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CMAJ Open. 2017 Jul 18;5(3):E570-E575. doi: 10.9778/cmajo.20170013.

Accuracy of administrative claims data for cerebral palsy diagnosis: a retrospective cohort study.

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Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que.



Cerebral palsy is the most common cause of childhood physical disability, with multiple associated comorbidities. Administrative claims data provide population-level prevalence estimates for cerebral palsy surveillance; however, their diagnostic accuracy has never been validated in Quebec. This study aimed to assess the accuracy of administrative claims data for the diagnosis of cerebral palsy.


We conducted a retrospective cohort study of children with cerebral palsy born between 1999 and 2002 within 6 health administrative regions of Quebec. Provincial cerebral palsy registry data (reference standard) and administrative physician claims were linked. We explored differences between true-positive and false-negative cases using subgroup sensitivity analysis.


A total of 301 children were identified with confirmed cerebral palsy from the provincial registry, for an estimated prevalence of 1.8 (95% confidence interval [CI] 1.6-2.1) per 1000 children 5 years of age. The sensitivity and specificity of administrative claims data for cerebral palsy were 65.5% (95% CI 59.8%-70.8%) and 99.9% (95% CI 99.9%-99.9%), respectively, yielding a prevalence of 2.0 (95% CI 1.9-2.3) per 1000 children 5 years of age. The positive and negative predictive values were 58.8% (95% CI 53.3%-64.1%) and 99.9% (95% CI 99.9%-99.9%), respectively. The κ value was 0.62 (95% CI 0.57-0.67). Administrative claims data were more sensitive for children from rural regions, born preterm, with spastic quadriparesis and with higher levels of motor impairment.


Administrative claims data do not capture the full spectrum of children with cerebral palsy. This suggests the need for a more sensitive case definition and caution when using such data without validation.

Conflict of interest statement

Competing interests: Maryam Oskoui reports grants from the SickKids Foundation during the conduct of the study. No other competing interests were declared.

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