Luquetti Daniela Varela, Koifman Rosalina Jorge
Post-graduation Program Environment and Public Health National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
J Registry Manag. 2010 Fall;37(3):112-20.
We sought to assess data validity and coding reliability of birth defects among Brazilian birth certificates (BC).
From a population of 27,945 live births delivered at 8 hospitals in 7 cities of Brazil during 2004, we compared 677 cases of birth defects identified through BC to 1,110 cases identified through a hospital-based birth defect registry.
Birth defects prevalence according to BC varied by hospital from 0.5% to 5.3%. Birth certificate sensitivity of birth defects reporting varied by hospital, from 11.4% to 66.5%. Specificity and positive and negative predictive values were above 80%. For reported cases, concordance of diagnosis was over 90% for all hospitals combined. Birth defects coding reliability, determined by kappa statistics, varied from 0.61 to 1.00 for 3-digit ICD-10 codes and 0.41 to 0.78 for 4-digit codes.
Birth certificate data underestimated birth defects prevalence among live births. Although concordance of diagnosis was high, the data should be used cautiously because of high underreporting and moderate coding reliability.
我们试图评估巴西出生证明（BC）中出生缺陷的数据有效性和编码可靠性。
从2004年巴西7个城市8家医院出生的27945例活产人群中，我们将通过出生证明识别出的677例出生缺陷病例与通过基于医院的出生缺陷登记处识别出的1110例病例进行了比较。
根据出生证明，各医院出生缺陷患病率从0.5%到5.3%不等。各医院出生缺陷报告的出生证明敏感性从11.4%到66.5%不等。特异性以及阳性和阴性预测值均高于80%。对于报告的病例，所有医院综合诊断的一致性超过90%。由kappa统计确定的出生缺陷编码可靠性，三位数字的ICD - 10编码从0.61到1.00不等，四位数字编码从0.41到0.78不等。
出生证明数据低估了活产中出生缺陷的患病率。尽管诊断一致性较高，但由于报告率低和编码可靠性中等，这些数据应谨慎使用。
