In Reply: We agree with Dr Kaczorowski that the increased rates of chronic conditions reported among children and youth could partly reflect better detection of conditions by physicians and parents in response to increased awareness and the availability of new treatments. We defined chronic conditions in this study using questions that asked parents about a child's health service need, functional limitations, and duration of condition. Parents then reported which specific conditions their child had. We presume that many of these conditions were properly diagnosed by a health care professional, but the method of using parental perceptions leaves open the possibility that some children were misdiagnosed, or that parents ascribed ongoing symptoms to a condition they thought their child had.
Van Cleave J, Gortmaker SL, Perrin JM. Chronic Health Conditions and Obesity Among Children and Youth—Reply. JAMA. 2010;303(19):1915-1916. doi:10.1001/jama.2010.586