The quality of routinely collected maternity data

Abstract

Objective To assess the validity of clinical information held on a regional maternity database, the St Mary's Maternity Information System (SMMIS). Design A retrospective review of 892 maternity case notes and matched SMMIS records, by a midwife trained in clinical coding techniques. Setting Three maternity units in the North West Thames Region. Main outcome measures Percentage agreement for 17 directly recorded SMMIS data items and equivalent data abstracted from the notes. Frequencies of diagnosis codes abstracted from case notes, as compared with those generated by SMMIS on the basis of directly recorded data. Results A generally high level of agreement was observed between the abstracts of the notes and the SMMIS records. Of the 17 data items examined, 10 showed 95% agreement or better, and all but two exceeded 80% agreement. Little difference was found between the levels of agreement observed at the three sites. A greater number and range of diagnosis codes were abstracted from the notes than were generated by SMMIS. Conclusions The directly recorded clinical data held on the SMMIS regional database is largely accurate and consistently recorded across a variety of units. The database can therefore be considered a valuable resource for the comparative audit of maternity practice. The SMMIS technique for deriving, on a semi‐automatic basis, diagnosis codes from the directly recorded fields, appears to work moderately well. We suggest that the direct method of data collection used in SMMIS could provide a model for other specialties in the National Health Service.

Characteristics Associated With Intending and Achieving a Planned Home Birth in the United Kingdom: An Observational Study of 515,777 Maternities in the North West Thames Region, 1988–2000

“…Studies have concluded that the completeness and quality of the information recorded within SMMIS is good. For example, studies comparing the information recorded on the computerised database against case notes found a very high degree of corroboration, and a high level of consistency across different hospitals (15,16). 6 The SMMIS database is extremely useful for the study of pregnancy outcomes by place of birth, because it overcomes many of the problems inherent within other UK data sources.…”

Maternal obesity and pregnancy outcome: a study of 287 213 pregnancies in London

“…The database has been previously validated for commonly recorded variables including intrauterine death. 13 BMI was calculated as weight at antenatal booking (kg), divided by height (m) squared. The subjects were divided into groups according to maternal BMI at booking using body mass groupings recommended by Abrams and Parker 14 (normal, BMI 20 -< 25; moderately obese, BMI 25 -< 30, and very obese, BMI > 30).…”

“…The aim of this study was to examine pregnancy outcome in obese women compared to those of normal weight by reviewing a large number of singleton pregnancies using a validated database. 13 We aimed to test the hypothesis that obesity, as determined by maternal body mass index (BMI), is associated with adverse outcomes for mother and baby, and to quantify this risk after allowing for possible confounding factors.…”

Grandmultiparae in a modern setting

“…Research performed by obtaining data from SMMIS 10 has been criticised in the past 11,12 on the grounds that such a database may be insufficiently accurate to support research. Cleary et al 13 addressed this issue by retrospectively comparing 892 maternity casenotes and matched SMMIS records and found that out of 17 data items compared there was 95% agreement or better for 10 items and all except two exceeded 80%. By performing a validation exercise in the current study we would not only strengthen the conclusions of the study, but also add to the literature on the validation of computerised maternity information systems.…”