Background: Administrative data are used for disease surveillance and research. A validated case definition to study pediatric traumatic brain injury(TBI)using administrative data is not available.

Methods: Using systematic review methodology, we identified studies validating TBI ICD coding. Second, a cohort of children with and without TBI from a pediatric emergency department (ER) was linked to administrative hospital and emergency databases. Nine ICD-10 based algorithms were tested. Sensitivity, specificity, and positive/negative predictive value (PPV, NPV) were calculated.

Results: We identified three studies from the systematic review with varying diagnostic accuracy, and none were pediatric specific. The best algorithm to identify TBI cases was, “1 Hospital or 1 ER visit in 1 year”: sensitivity 69.8%, (67.3-72.2), specificity 96.7% (96.2-97.2), PPV 84.2% (82.0-86.3), NPV 92.7% (92.0-93.3).

Conclusion: This study algorithm is best to capture ER or hospitalized TBI cases. Future research should develop algorithms which include children seen in the community.