Document Detail

Validation of an algorithm to estimate gestational age in electronic health plan databases.
MedLine Citation:
PMID:  23335117     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To validate an algorithm that uses delivery date and diagnosis codes to define gestational age at birth in electronic health plan databases.
METHODS: Using data from 225,384 live born deliveries to women aged 15-45 years in 2001-2007 within eight of the 11 health plans participating in the Medication Exposure in Pregnancy Risk Evaluation Program, we compared (1) the algorithm-derived gestational age versus the "gold-standard" gestational age obtained from the infant birth certificate file and (2) the prenatal exposure status of two antidepressants (fluoxetine and sertraline) and two antibiotics (amoxicillin and azithromycin) as determined by the algorithm-derived versus the gold-standard gestational age.
RESULTS: The mean algorithm-derived gestational age at birth was lower than the mean obtained from the birth certificate file among singleton deliveries (267.9 vs 273.5 days) but not among multiple-gestation deliveries (253.9 vs 252.6 days). The algorithm-derived prenatal exposure to the antidepressants had a sensitivity and a positive predictive value of ≥95%, and a specificity and a negative predictive value of almost 100%. Sensitivity and positive predictive value were both ≥90%, and specificity and negative predictive value were both >99% for the antibiotics.
CONCLUSIONS: A gestational age algorithm based upon electronic health plan data correctly classified medication exposure status in most live born deliveries, but trimester-specific misclassification may be higher for drugs typically used for short durations.
Qian Li; Susan E Andrade; William O Cooper; Robert L Davis; Sascha Dublin; Tarek A Hammad; Pamala A Pawloski; Simone P Pinheiro; Marsha A Raebel; Pamela E Scott; David H Smith; Inna Dashevsky; Katherine Haffenreffer; Karin E Johnson; Sengwee Toh
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Validation Studies     Date:  2013-01-21
Journal Detail:
Title:  Pharmacoepidemiology and drug safety     Volume:  22     ISSN:  1099-1557     ISO Abbreviation:  Pharmacoepidemiol Drug Saf     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-03     Completed Date:  2013-11-12     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  9208369     Medline TA:  Pharmacoepidemiol Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  524-32     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 John Wiley & Sons, Ltd.
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MeSH Terms
Anti-Bacterial Agents / administration & dosage
Antidepressive Agents / administration & dosage
Birth Certificates
Databases, Factual / statistics & numerical data*
Delivery, Obstetric / statistics & numerical data*
Gestational Age*
Infant, Newborn
International Classification of Diseases
Middle Aged
Pharmacoepidemiology / methods
Predictive Value of Tests
Pregnancy, Multiple
Sensitivity and Specificity
Young Adult
Grant Support
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antidepressive Agents

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