Validation of Obstetric Diagnosis and Procedure Codes in the Danish National Patient Registry in 2017

IF 3.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Clinical Epidemiology Pub Date : 2024-02-21 DOI:10.2147/clep.s441123
Kamille Herskind, Peter Bjødstrup Jensen, Christina Anne Vinter, Lone Krebs, Lene Friis Eskildsen, Anne Broe, Anton Pottegård, Mette Bliddal
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Abstract

Purpose: This study aimed to systematically evaluate the validity of variables related to pregnancy, delivery, and key characteristics of the infant in the Danish National Patient Register using maternal medical records as the reference standard.
Patients and Methods: We reviewed medical records of 1264 women giving birth in the Region of Southern Denmark during 2017. We calculated positive (PPV) and negative (NPV) predictive values, sensitivity, and specificity to estimate the validity of 49 selected variables.
Results: The PPV was ≥ 0.90 on most pregnancy-related variables including parity, pre-gestational BMI, diabetes disorders, and previous cesarean section, while it was lower for hypertensive disorders, especially mild to moderate preeclampsia (0.49, 95% CI 0.32– 0.66). Sensitivity ranged from 0.80 to 1.00 on all pregnancy-related variables, except hypertensive disorders (sensitivity 0.38– 0.71, lowest for severe preeclampsia). On most delivery-related variables including obstetric surgical procedures (eg cesarean section and induction of labor), pharmacological pain-relief, and gestational age at delivery, PPV’s ranged from 0.98 to 1.00 and the corresponding sensitivities from 0.87 to 1.00. Regarding infant-related variables, both the APGAR score registered five minutes after delivery and birthweight yielded a PPV of 1.00.
Conclusion: Obstetric coding in the Danish National Patient Register shows very high validity and completeness making it a valuable source for epidemiologic research.

Plain Language Summary: Danish register data are often used for epidemiological research in reproduction. The registers are based on coded information to the registers based on information from medical records. The quality of the register data is highly dependent of the validity of the codes. Yet there is a lack in our knowledge of the validity of data related to pregnancy, childbirth, and the characteristics of the newborn baby. We therefore aimed to validate the Danish National Patient Registry data related to pregnancy and childbirth by comparing the registered code with information from the medical records.
We scrutinized medical records from 1264 women giving birth in the Region of Southern Denmark during 2017. We compared the registration in the medical record with the registered code in the Danish National Patient Registry by calculating how accurate the register data are according to 49 different variables.
Results showed that registered codes in the Patient Registry for pregnancy- and childbirth-related conditions and key infant characteristics were to a high degree in agreement with the data from the medical report with few exceptions.
In conclusion, the study revealed that the Danish National Patient Register provides highly accurate and comprehensive data for most pregnancy, delivery, and infant-related variables. This underscores the register’s value as a reliable source for epidemiologic research in reproductive health.

Keywords: registries, sensitivity and specificity, validity, epidemiology, pregnancy, delivery
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2017年丹麦全国患者登记册中产科诊断和手术代码的验证
目的:本研究旨在以产妇医疗记录为参考标准,系统评估丹麦全国患者登记册中与妊娠、分娩和婴儿主要特征有关的变量的有效性:我们查阅了 2017 年丹麦南部地区 1264 名产妇的医疗记录。我们计算了阳性(PPV)和阴性(NPV)预测值、灵敏度和特异性,以估计 49 个选定变量的有效性:大多数与妊娠相关的变量,包括奇偶数、妊娠前体重指数、糖尿病疾病和既往剖宫产,其PPV均≥0.90,而高血压疾病,尤其是轻度至中度子痫前期的PPV较低(0.49,95% CI 0.32-0.66)。除高血压疾病(灵敏度为 0.38-0.71,重度子痫前期灵敏度最低)外,所有妊娠相关变量的灵敏度在 0.80 至 1.00 之间。在大多数分娩相关变量中,包括产科手术(如剖宫产和引产)、药物镇痛和分娩时胎龄,PPV 为 0.98 至 1.00,相应的灵敏度为 0.87 至 1.00。关于婴儿相关变量,产后 5 分钟登记的 APGAR 评分和出生体重的 PPV 值均为 1.00:丹麦全国患者登记册中的产科编码显示出极高的有效性和完整性,使其成为流行病学研究的重要来源。登记册是基于医疗记录信息的编码信息。登记数据的质量在很大程度上取决于编码的有效性。然而,我们对怀孕、分娩和新生儿特征相关数据的有效性还缺乏了解。因此,我们旨在通过比较登记代码和医疗记录信息,验证丹麦全国患者登记册中与怀孕和分娩相关的数据。我们仔细研究了 2017 年丹麦南部地区 1264 名产妇的医疗记录。结果显示,患者登记册中与妊娠和分娩相关的病症以及主要婴儿特征的登记编码与医疗报告中的数据高度一致,只有少数例外。总之,研究表明,丹麦国家患者登记册为大多数与妊娠、分娩和婴儿相关的变量提供了高度准确和全面的数据。关键词:登记册、敏感性和特异性、有效性、流行病学、妊娠、分娩
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来源期刊
Clinical Epidemiology
Clinical Epidemiology Medicine-Epidemiology
CiteScore
6.30
自引率
5.10%
发文量
169
审稿时长
16 weeks
期刊介绍: Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.
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