Martin Joyce A, Wilson Elizabeth C, Osterman Michelle J K, Saadi Elizabeth W, Sutton Shae R, Hamilton Brady E
Natl Vital Stat Rep. 2013 Jul 22;62(2):1-19.
A primary goal of the 2003 revision of the U.S. Standard Certificate of Live Birth was to improve data quality, in part by improving data sources, definitions, and instructions. This report evaluates the quality of selected medical and health data from the 2003 revision of the birth certificate by comparing birth certificate data with information abstracted from hospital medical records.
A random sample of records for 600 births that occurred in 2010-2011 in State A, and a convenience sample of 495 births that occurred in State B in 2009 were reviewed. Birth certificate and hospital medical record data were compared for these categories: pregnancy history, prenatal care, gestational age, birthweight, pregnancy risk factors, obstetric procedures, onset of labor, source of payment, characteristics of labor and delivery, fetal presentation, method of delivery, abnormal conditions of the newborn, infant living, and infant breastfed. Levels of missing data, exact agreement, kappa scores, sensitivity, and false discovery rates are presented, where applicable.
Exact agreement or sensitivity, was high for a number of items for both states (e.g., number of cesarean deliveries, cephalic presentation, cesarean delivery, and birthweight within 500 grams), but exact agreement or sensitivity was low or extremely low for both states for several items (e.g., total number of prenatal visits, previous preterm birth, meconium staining, and fetal intolerance of labor) (Figure 1). Levels of agreement or sensitivity for most items (e.g., prenatal care beginning in first trimester and source of payment-private insurance) were substantial or moderate. Data quality varied by state, and often, varied widely by hospital.
2003年美国标准出生证明修订版的一个主要目标是提高数据质量，部分是通过改善数据来源、定义和说明来实现。本报告通过将出生证明数据与从医院病历中提取的信息进行比较，评估了2003年出生证明修订版中选定的医疗和健康数据的质量。
对A州2010 - 2011年发生的600例出生记录进行随机抽样，并对B州2009年发生的495例出生记录进行便利抽样审查。对这些类别比较出生证明和医院病历数据：妊娠史、产前护理、孕周、出生体重、妊娠风险因素、产科操作、分娩发动、支付来源、分娩特征、胎位、分娩方式、新生儿异常情况、婴儿存活情况和婴儿母乳喂养情况。在适用的情况下，列出了缺失数据水平、完全一致性、kappa分数、敏感性和错误发现率。
两个州的许多项目的完全一致性或敏感性都很高（例如，剖宫产数量、头位、剖宫产以及500克以内的出生体重），但两个州的几个项目的完全一致性或敏感性较低或极低（例如，产前检查总数、既往早产、胎粪污染和胎儿窘迫）（图1）。大多数项目的一致性或敏感性水平（例如，孕早期开始的产前护理和支付来源——私人保险）为实质性或中等。数据质量因州而异，而且通常在不同医院之间差异很大。
