Validation of algorithms to identify adverse perinatal outcomes in the Medicaid Analytic Extract database
| Autor: | Jennifer Cottral, Krista F. Huybrechts, David J. Combs, Kathryn J. Gray, Sonia Hernandez-Diaz, Devan Bartels, Beryl L. Manning-Geist, Sara Z. Dejene, Brian T. Bateman, Loreen Straub, Helen Mogun, Stacey Burns, Mengdong He, Rebecca M. Reimers |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Databases Factual Epidemiology computer.software_genre 030226 pharmacology & pharmacy Congenital Abnormalities 03 medical and health sciences 0302 clinical medicine Pregnancy Humans Medicine Pharmacology (medical) 030212 general & internal medicine Database Placental abruption Medicaid business.industry Medical record Gold standard Infant Newborn Pregnancy Outcome Pharmacoepidemiology medicine.disease United States Confidence interval Pregnancy Complications Perinatal Care Cohort Small for gestational age Female business Algorithm computer Algorithms |
| Zdroj: | Pharmacoepidemiology and Drug Safety. 29:419-426 |
| ISSN: | 1099-1557 1053-8569 |
| Popis: | Background The Medicaid Analytic eXtract (MAX) is a health care utilization database from publicly insured individuals that has been used for studies of drug safety in pregnancy. Claims-based algorithms for defining many important maternal and neonatal outcomes have not been validated. Objective To validate claims-based algorithms for identifying selected pregnancy outcomes in MAX using hospital medical records. Methods The medical records of mothers who delivered between 2000 and 2010 within a single large healthcare system were linked to their claims in MAX. Claims-based algorithms for placental abruption, preeclampsia, postpartum hemorrhage, small for gestational age, and noncardiac congenital malformation were defined. Fifty randomly sampled cases for each outcome identified using these algorithms were selected, and their medical records were independently reviewed by two physicians to confirm the presence of the diagnosis of interest; disagreements were resolved by a third physician reviewer. Positive predictive values (PPVs) and 95% confidence intervals (CIs) of the claims-based algorithms were calculated using medical records as the gold standard. Results The linked cohort included 10,899 live-birth pregnancies. The PPV was 92% (95% CI, 82%-97%) for placental abruption, 82% (95% CI, 70%-91%) for preeclampsia, 74% (95% CI, 61%-85%) for postpartum hemorrhage, 92% (95% CI, 82%-97%) for small for gestational age, and 86% (95% CI, 74%-94%) for noncardiac congenital malformation. Conclusions Across the perinatal outcomes considered, PPVs ranged between 74% and 92%. These PPVs can inform bias analyses that correct for outcome misclassification. |
| Databáze: | OpenAIRE |
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