Evaluation of gestational age and admission date assumptions used to determine prenatal drug exposure from administrative data
Evaluation of gestational age and admission date assumptions used to determine prenatal drug exposure from administrative data
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DOI：
10.1002/pds.1100
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发表时间：
2005-12-01
影响因子：
2.6
通讯作者：
Andrade, SE
中科院分区：
文献类型：
--
作者：
Raebel, MA;Ellis, JL;Andrade, SE
目的评价270天胎龄和分娩日期的假设用于评估产前药物暴露的行政数据集研究，并与出生登记中包含的信息进行比较。研究设计和设置Kaiser Permanente科罗拉多（KPCO），健康维护组织（HMO）治疗学教育和研究网络中心（CERT）的成员，之前参加了一项CERT研究，该研究使用索赔数据来评估产前药物暴露。在目前的研究中，将CERT研究数据集（妊娠期间安全处方数据集（PSDPD））的胎龄和分娩信息与KPCO出生登记中的信息进行了比较。评估了分娩索赔数据的敏感性和阳性预测值（PPV）。出生登记处的平均孕龄为273（中位数= 275）天的产前药物exposed.Results分类的孕龄和分娩日期的假设的效果进行了评估。索赔数据在确定交付时的敏感性为97.6%，PPV为98.2%。在仅一个数据集中确定的分娩中，45%与胎龄假设有关，36%是由于索赔数据问题。对于所有药物暴露类别，对妊娠期间处方流行率估计值的影响是绝对变化1%或更小。对于X类，药物暴露在第一个三个月，处方患病率的相对变化为13.7%（p = 0.014）。结论行政数据库可以用于评估产前药物暴露，但胎龄假设可能会导致一小部分的错误分类。版权所有（c）2005年约翰威利父子有限公司。
Objective Our aim was to evaluate the 270-day gestational age and delivery date assumptions used in an administrative dataset study assessing prenatal drug exposure compared to information contained in a birth registry.Study Design and Setting Kaiser Permanente Colorado (KPCO), a member of the Health Maintenance Organization (HMO) Research Network Center for Education and Research in Therapeutics (CERTs), previously participated in a CERTs study that used claims data to assess prenatal drug exposure. In the current study, gestational age and deliveries information from the CERTs study dataset, the Prescribing Safely during Pregnancy Dataset (PSDPD), was compared to information in the KPCO Birth Registry. Sensitivity and positive predictive value (PPV) of the claims data for deliveries were assessed. The effect of gestational age and delivery date assumptions on classification of prenatal drug exposure was evaluated.Results The mean gestational age in the Birth Registry was 273 (median= 275) days. Sensitivity of claims data at identifying deliveries was 97.6%, PPV was 98.2%. Of deliveries identified in only one dataset, 45% were related to the gestational age assumption and 36% were due to claims data issues. The effect on estimates of prevalence of prescribing during pregnancy was an absolute change of 1% or less for all drug exposure categories. For Category X, drug exposures during the first trimester, the relative change in prescribing prevalence was 13.7% (p = 0.014).Conclusion Administrative databases can be useful for assessing prenatal drug exposure, but gestational age assumptions can result in a small proportion of misclassification. Copyright (c) 2005 John Wiley & Sons, Ltd.