Meyers Primary Care Institute and University of Massachusetts Medical School, Worcester, MA, USA.
Pharmacoepidemiol Drug Saf. 2013 Jan;22(1):7-15. doi: 10.1002/pds.3319. Epub 2012 Jul 3.
To evaluate the validity of health plan and birth certificate data for pregnancy research.
A retrospective study was conducted using administrative and claims data from 11 U.S. health plans and corresponding birth certificate data from state health departments. Diagnoses, drug dispensings, and procedure codes were used to identify infant outcomes (cardiac defects, anencephaly, preterm birth, and neonatal intensive care unit [NICU] admission) and maternal diagnoses (asthma and systemic lupus erythematosus [SLE]) recorded in the health plan data for live born deliveries between January 2001 and December 2007. A random sample of medical charts (n = 802) was abstracted for infants and mothers identified with the specified outcomes. Information on newborn, maternal, and paternal characteristics (gestational age at birth, birth weight, previous pregnancies and live births, race/ethnicity) was also abstracted and compared to birth certificate data. Positive predictive values (PPVs) were calculated with documentation in the medical chart serving as the gold standard.
PPVs were 71% for cardiac defects, 37% for anencephaly, 87% for preterm birth, and 92% for NICU admission. PPVs for algorithms to identify maternal diagnoses of asthma and SLE were ≥ 93%. Our findings indicated considerable agreement (PPVs > 90%) between birth certificate and medical record data for measures related to birth weight, gestational age, prior obstetrical history, and race/ethnicity.
Health plan and birth certificate data can be useful to accurately identify some infant outcomes, maternal diagnoses, and newborn, maternal, and paternal characteristics. Other outcomes and variables may require medical record review for validation.
评估健康计划和出生证明数据在妊娠研究中的有效性。
采用来自 11 个美国健康计划的行政和索赔数据以及州卫生部门的相应出生证明数据进行回顾性研究。使用诊断、药物配药和程序代码来识别健康计划数据中记录的活产儿结局（心脏缺陷、无脑畸形、早产和新生儿重症监护病房[NICU]入院）和产妇诊断（哮喘和系统性红斑狼疮[SLE]）。对 2001 年 1 月至 2007 年 12 月期间出生的活产儿进行了随机抽取 802 份医疗记录进行摘录。摘录了有关新生儿、产妇和父亲特征（出生时的胎龄、出生体重、既往妊娠和活产儿、种族/民族）的信息，并与出生证明数据进行了比较。以医疗记录中的记录作为金标准，计算了阳性预测值（PPV）。
心脏缺陷的 PPV 为 71%，无脑畸形为 37%，早产为 87%，NICU 入院为 92%。用于识别哮喘和 SLE 产妇诊断的算法的 PPV 均≥93%。我们的研究结果表明，出生证明和医疗记录数据在与出生体重、胎龄、既往产科史和种族/民族相关的措施方面具有相当大的一致性（PPV>90%）。
健康计划和出生证明数据可用于准确识别某些婴儿结局、产妇诊断以及新生儿、产妇和父亲特征。其他结局和变量可能需要医疗记录审查进行验证。
