Positive predictive value of computerized records for major congenital malformations

Cooper, William O.; Hernández–Dı́az, Sonia; Gideon, Patricia; Dyer, Shannon; Hall, Kathleen; Dudley, Judith A.; Cevasco, Marisa; Thompson, Amanda; Ray, Wayne A.

doi:10.1002/pds.1534

Cited by 54 publications

(64 citation statements)

References 10 publications

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“…In our study, Medicaid claims data had poor predictive value (29%) for identifying true cases of HSCR, particularly for Alaska non-Native infants. Our findings support the work of other authors who have suggested the need for medical record confirmation of birth defects data obtained from Medicaid claims data (Grisso et al, 1997;Cooper et al, 2008).…”

Section: Discussionsupporting

confidence: 92%

“…Several publications have reported states' use of Medicaid data for identification of children with birth defects; but, with respect to correctly identifying cases, these reports did not evaluate the specific benefits or limitations of using Medicaid data for this purpose (Morgan et al, 2000;Shaw-Taylor, 2001; National Birth Defects Prevention Network, 2008). We are not aware of previous studies that have assessed the source-specific PPV of a complete Medicaid claims database for birth defects surveillance, but Cooper et al (2008) reported PPVs for specific conditions ranging from 34.3 to 93.1% using a combination of Medicaid inpatient claims and birth certificates for identifying cases of specific birth defects. (Alaska does not use vital records as a reporting source for birth defects surveillance because of the low validity of birth certificates for this purpose [Watkins et al, 1996]).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

False positive reporting of Hirschsprung's disease in Alaska: An evaluation of Hirschsprung's disease surveillance, birth years 1996–2007

Schoellhorn

Collins

2009

Birth Defects Research

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

False positive reporting of Hirschsprung's disease in Alaska: An evaluation of Hirschsprung's disease surveillance, birth years 1996–2007

Schoellhorn

Collins

2009

Birth Defects Research

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“…The gestational age recorded in birth certificates is typically calculated from an algorithm that uses information on LMP (based on maternal recall), ultrasound and clinical assessment; a study that used data from the same population (TennCare, 1985-2002) and data system as the one used for our study showed a concordance of 94% between the date of the LMP in birth certificates and medical records; 18 We determined the percentile for birthweight for each infant based on the gestational age using sex-specific references. 19 SGA infants were defined as those with a birthweight below the 10 th percentile for their gestational age.…”

Section: Methodsmentioning

confidence: 99%

Antiretroviral Therapy Use During Pregnancy and the Risk of Small for Gestational Age Birth in a Medicaid Population

Phiri¹,

Williams

Dugan³

et al. 2015

Pediatric Infectious Disease Journal

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Background Several studies have assessed the association between antiretroviral (ARV) therapy use during pregnancy and small for gestational age (SGA), but the evidence remains incompletely elucidated. Methods We linked data from Tennessee Medicaid files and vital records to evaluate pregnancies among human immunodeficiency virus (HIV)-infected women who delivered between 1994 and 2009.Maternal HIV status was defined based on diagnosis codes, ARV prescriptions, and laboratory codes for CD4 count or HIV RNA assays. ARV use was identified from pharmacy claims. Risk of SGA (defined as birthweight below the 10th percentile for gestational age) and preterm birth were evaluated using logistic regression models. Results 477 HIV- infected pregnant women contributing 604 singleton pregnancies were identified; 156 (26%) delivered SGA infants. ARV use during pregnancy was not associated with SGA (adjusted odds ratio [aOR] = 0.93; 95% confidence interval [CI], 0.56-1.56) or preterm birth (aOR = 0.74; 95% CI, 0.42-1.32). Exposure to a protease inhibitor (PI) during the first trimester was associated with a lower risk of SGA (OR, 0.54; 95% CI, 0.29-1.01) compared to non-exposure to a PI throughout pregnancy. Conclusions We observed no evidence of an association between ARV exposure during pregnancy and SGA delivery in this Medicaid cohort of HIV-infected women.

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“…Billing codes for major birth defects in a single claim have a low positive predictive value (typically 50% to 70%). 11, 14, 15 We calculated incremental expenditures for preterm birth, both overall and excluding infants with major birth defects.…”

Section: Methodsmentioning

confidence: 99%

Employer-Sponsored Plan Expenditures for Infants Born Preterm

et al. 2017

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BACKGROUND Care for infants born preterm or with major birth defects is costly. Specific estimates of financial burden for different payers are lacking, in part because use of administrative data to identify preterm infants and costs is challenging. METHODS We used private health insurance claims data and billing codes to identify live births during 2013 and calculated first-year expenditures for employer-sponsored health plans for infants born preterm, both overall and stratified by major birth defects. RESULTS We conservatively estimated that 7.7% of insured infants born preterm accounted for 37% of $2.0 billion spent by participating plans on the care of infants born during 2013. With a mean difference in plan expenditures of ~$47 100 per infant, preterm births cost the included plans an extra $600 million during the first year of life. Extrapolating to the national level, we projected aggregate employer-sponsored plan expenditures of $6 billion for infants born preterm during 2013. Infants with major birth defects accounted for 5.8% of preterm births but 24.5% of expenditures during infancy. By using an alternative algorithm to identify preterm infants, it was revealed that incremental expenditures were higher: $78 000 per preterm infant and $14 billion nationally. CONCLUSION Preterm births (especially in conjunction with major birth defects) represent a substantial burden on payers, and efforts to mitigate this burden are needed. In addition, researchers need to conduct studies using linked vital records, birth defects surveillance, and administrative data to accurately and longitudinally assess per-infant costs attributable to preterm birth and the interaction of preterm birth with major birth defects.

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Positive predictive value of computerized records for major congenital malformations

Cited by 54 publications

References 10 publications

False positive reporting of Hirschsprung's disease in Alaska: An evaluation of Hirschsprung's disease surveillance, birth years 1996–2007

False positive reporting of Hirschsprung's disease in Alaska: An evaluation of Hirschsprung's disease surveillance, birth years 1996–2007

Antiretroviral Therapy Use During Pregnancy and the Risk of Small for Gestational Age Birth in a Medicaid Population

Employer-Sponsored Plan Expenditures for Infants Born Preterm

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