Validation of claims‐based algorithms to identify non‐live birth outcomes

Purpose Perinatal epidemiology studies using healthcare utilization databases are often restricted to live births, largely due to the lack of established algorithms to identify non‐live births. The study objective was to develop and validate claims‐based algorithms for the ascertainment of non‐live...

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Veröffentlicht in:Pharmacoepidemiology and drug safety Jg. 32; H. 4; S. 468 - 474
Hauptverfasser: Zhu, Yanmin, Bateman, Brian T., Hernandez‐Diaz, Sonia, Gray, Kathryn J., Straub, Loreen, Reimers, Rebecca M., Manning‐Geist, Beryl, Yoselevsky, Elizabeth, Taylor, Lockwood G., Ouellet‐Hellstrom, Rita, Ma, Yong, Qiang, Yandong, Hua, Wei, Huybrechts, Krista F.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Chichester, UK John Wiley & Sons, Inc 01.04.2023
Wiley Subscription Services, Inc
Schlagworte:
Abortion, Spontaneous - epidemiology
Algorithms
Birth
Births
claims‐based algorithm
Databases, Factual
Diagnosis
Epidemiology
Female
Health care
Health services utilization
Humans
Miscarriage
positive predictive value
Pregnancy
Pregnancy Outcome - epidemiology
spontaneous abortion
Stillbirth
Stillbirth - epidemiology
termination
validation study
positive predictive value
termination
stillbirth
spontaneous abortion
validation study
claims-based algorithm
ISSN:1053-8569, 1099-1557, 1099-1557
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Zusammenfassung:Purpose Perinatal epidemiology studies using healthcare utilization databases are often restricted to live births, largely due to the lack of established algorithms to identify non‐live births. The study objective was to develop and validate claims‐based algorithms for the ascertainment of non‐live births. Methods Using the Mass General Brigham Research Patient Data Registry 2000–2014, we assembled a cohort of women enrolled in Medicaid with a non‐live birth. Based on ≥1 inpatient or ≥2 outpatient diagnosis/procedure codes, we identified and randomly sampled 100 potential stillbirth, spontaneous abortion, and termination cases each. For the secondary definitions, we excluded cases with codes for other pregnancy outcomes within ±5 days of the outcome of interest and relaxed the definitions for spontaneous abortion and termination by allowing cases with one outpatient diagnosis only. Cases were adjudicated based on medical chart review. We estimated the positive predictive value (PPV) for each outcome. Results The PPV was 71.0% (95% CI, 61.1–79.6) for stillbirth; 79.0% (69.7–86.5) for spontaneous abortion, and 93.0% (86.1–97.1) for termination. When excluding cases with adjacent codes for other pregnancy outcomes and further relaxing the definition, the PPV increased to 80.6% (69.5–88.9) for stillbirth, 86.6% (80.5–91.3) for spontaneous abortion and 94.9% (91.1–97.4) for termination. The PPV for the composite outcome using the relaxed definition was 94.4% (92.3–96.1). Conclusions Our findings suggest non‐live birth outcomes can be identified in a valid manner in epidemiological studies based on healthcare utilization databases.
Bibliographie:Funding information
The U.S. Food and Drug Administration (FDA) through the Department of Health and Human Services, Grant/Award Number: HHSF223201400043I
This study was presented at the 35th International Conference on Pharmacoepidemiology & Therapeutic Risk Management, August 2019, Philadelphia, USA.
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ISSN:1053-8569
1099-1557
1099-1557
DOI:10.1002/pds.5574