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Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

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Adjusting for multiple-misclassified variables in a study using birth certificates.

Anne M Jurek¹, Sander Greenland

¹Center for Healthcare Research & Innovation, Allina Health, Minneapolis, MN 55407, USA. jure0007@umn.edu

Annals of Epidemiology

|June 27, 2013

Summary

Birth certificate data on maternal smoking and cleft lip/palate is often inaccurate. Adjusting for errors significantly changes the association estimates, highlighting the need for quantitative methods to account for data uncertainties in epidemiological studies.

Keywords:

Bias Birth certificates Cigarette smoking Cleft lip and palate Misclassification Sensitivity analysis Sensitivity and specificity

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Area of Science:

Epidemiology
Public Health
Biostatistics

Background:

Birth certificates are a common data source for epidemiological research.
However, significant inaccuracies in birth certificate data are well-documented.
Studies often do not account for these data errors.

Purpose of the Study:

To investigate the association between maternal cigarette smoking and cleft lip and palate using birth certificate data.
To assess the impact of data misclassification on this association.

Main Methods:

Adjusted odds ratio estimates for simultaneous exposure and outcome misclassification.
Calculated odds ratios adjusted for exposure misclassification only.
Calculated odds ratios adjusted for outcome misclassification only.

Main Results:

Adjusted odds ratios varied widely, from <1.0 to >>1.16 (unadjusted estimate).
Most adjusted estimates fell outside the 95% confidence limits of the unadjusted estimate.
The association between maternal smoking and clefting was substantially altered by error adjustment.

Conclusions:

Birth certificate classification errors can significantly impact study findings.
Inferences from birth certificate data should incorporate quantitative methods to address data uncertainties.
Researchers should be cautious when interpreting results based on potentially inaccurate birth records.