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Validating the use of ICD-9-CM codes to evaluate gestational age and birth weight

John P Barrett, Carter J Sevick, Ava Marie S Conlin

    Journal of Registry Management
    |April 20, 2013
    PubMed

    Insights

    Electronically derived ICD-9-CM codes accurately assess gestational age and low birth weight in military infants. This supports the reliability of the Department of Defense Birth and Infant Health Registry for public health surveillance.

    Area of Science:

    • Public Health
    • Reproductive Health Surveillance
    • Biostatistics

    Background:

    • Reducing preterm and low-weight births is a global public health priority.
    • Surveillance systems are crucial for monitoring reproductive health outcomes.
    • The Department of Defense (DoD) Birth and Infant Health Registry (Registry) uses electronic data for this purpose.

    Purpose of the Study:

    • To evaluate the accuracy of electronically derived International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for gestational age and birth weight.
    • To compare electronic Registry data with actual medical records for infants in the DoD Birth and Infant Health Registry.

    Main Methods:

    • Compared electronic Registry data with 1,858 randomly selected infant birth medical records from 17 military treatment facilities (MTFs).
    • Utilized descriptive statistics and the kappa statistic to measure agreement between electronic data and medical records.
    • Analyzed data for infants born between 1999 and 2002.

    Main Results:

    • Near-perfect agreement was found between electronic codes and medical records for preterm births (kappa=0.83) and low birth weight (kappa=0.87).
    • 1,669 of 1,858 reviewed records were successfully matched to the Registry dataset.
    • Agreement levels were consistent across various subgroups, including those with birth defects or different military service characteristics.

    Conclusions:

    • Electronically derived ICD-9-CM codes accurately reflect gestational age and low birth weight in the Registry.
    • The findings validate the integrity of Registry data for research on preterm and low-weight births in U.S. service member families.
    Abstract

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