Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;30(2):266-274.
doi: 10.1002/pds.5177. Epub 2020 Dec 3.

Developing algorithms for identifying major structural birth defects using automated electronic health data

Elyse O Kharbanda  1 , Gabriela Vazquez-Benitez  1 , Malini B DeSilva  1 , Alicen B Spaulding  2 , Matthew F Daley  3 , Allison L Naleway  4 , Stephanie A Irving  4 , Nicola P Klein  5 , Hung Fu Tseng  6 , Lisa A Jackson  7 , Simon J Hambidge  8 , Oluwatosin Olaiya  9 , Catherine A Panozzo  10 , Tanya R Myers  11 , Paul A Romitti  12
Affiliations

Developing algorithms for identifying major structural birth defects using automated electronic health data

Elyse O Kharbanda et al. Pharmacoepidemiol Drug Saf. 2021 Feb.

Abstract

Purpose: Given the 2015 transition to International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic coding, updates to our previously published algorithms for major structural birth defects (BDs) were necessary. Aims of this study were to update, validate, and refine algorithms for identifying selected BDs, and then to use these algorithms to describe BD prevalence in the vaccine safety datalink (VSD) population.

Methods: We converted our ICD-9-CM list of selected BDs to ICD-10-CM using available crosswalks with manual review of codes. We identified, chart reviewed, and adjudicated a sample of infants in the VSD with ≥2 ICD-10-CM diagnoses for one of seven common BDs. Positive predictive values (PPVs) were calculated; for BDs with suboptimal PPV, algorithms were refined. Final automated algorithms were applied to a cohort of live births delivered 10/1/2015-9/30/2017 at eight VSD sites to estimate BD prevalence. This research was approved by the HealthPartners Institutional Review Board, by all participating VSD sites, and by the CDC, with a waiver of informed consent.

Results: Of 573 infants with ≥2 diagnoses for a targeted BD, on adjudication, we classified 399 (69.6%) as probable cases, 31 (5.4%) as possible cases and 143 (25.0%) as not having the targeted BD. PPVs for the final BD algorithms ranged from 0.76 (hypospadias) to 1.0 (gastroschisis). Among 212 857 births over 2 years following transition to ICD-10-CM coding, prevalence for the full list of selected defects in the VSD was 1.8%.

Conclusions: Algorithms can identify infants with selected BDs using automated healthcare data with reasonable accuracy. Our updated algorithms can be used in observational studies of maternal vaccine safety and may be adapted for use in other surveillance systems.

Keywords: ICD-10; birth defects; pharmacoepidemiology; pregnancy.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kharbanda EO, Vazquez-Benitez G, Romitti PA, et al. Identifying birth defects in automated data sources in the vaccine safety datalink. Pharmacoepidemiol Drug Saf. 2017;26(4):412–420. - PMC - PubMed
    1. Friedman JM. Editorial in bed with the devil: recognizing human teratogenic exposures. Birth Defects Res. 2017;109(18):1407–1413. - PubMed
    1. Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines. MMWR Recomm Rep. 2016;65(5): 1–54. - PubMed
    1. Omer SB. Maternal immunization. N Engl J Med. 2017;376(13):1256–1267. - PubMed
    1. Naleway AL, Kurosky S, Henninger ML, et al. Vaccinations given during pregnancy, 2002–2009: a descriptive study. Am J Prev Med. 2014; 46(2):150–157. - PubMed

Publication types