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[The validity of the Spanish Minimum Basic Data Set to identify congenital anomalies in the Valencian Community
Clara Cavero-Carbonell1, Silvia Gimeno-Martos2, Óscar Zurriaga3
1Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-UV, Valencia, España.
Insights
The Spanish Minimum Basic Data Set (MBDS) is a key resource for identifying major congenital anomalies in the Valencian Community. However, its accuracy is limited by a significant number of false positive diagnoses.
Area of Science:
- Public Health
- Epidemiology
- Medical Informatics
Background:
- The Spanish Minimum Basic Data Set (MBDS) is a crucial administrative database for healthcare surveillance.
- Accurate identification of major congenital anomalies is essential for public health monitoring and intervention.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the MBDS for major congenital anomalies in children under one year old in the Valencian Community.
- To determine the positive and negative predictive values and sensitivity of the MBDS for congenital anomaly coding.
Main Methods:
- A retrospective epidemiological study analyzed MBDS data from 2007 for children under one year in the Valencian Community.
- Cases with congenital anomaly codes (740-759 CIE9-MC) were compared against clinical documentation.
- Diagnostic consistency was assessed using positive/negative predictive values, sensitivity, and the kappa test.
Main Results:
- The study identified 1651 patients with 2305 discharges; 4 out of 5434 sampled patients had major congenital abnormalities.
- MBDS demonstrated a positive predictive value of 56.4% and a negative predictive value of 99.3%.
- Sensitivity for detecting major congenital anomalies was 68.6%, with atrial septal defect, ventricular septal defect, and patent ductus arteriosus being common true positives.
Conclusions:
- The MBDS serves as a primary data source for the Valencian Community's congenital anomaly registry.
- A significant limitation of the MBDS is the high proportion of false positive cases identified, impacting data precision.
Objective:
To assess the validity of the Spanish Minimum Basic Data Set (MBDS) for identifying major congenital anomalies in the Valencian Community.
Methods:
A retrospective epidemiological study was carried out. Children under the age of one year, born in 2007 and residing in the Valencian Community with congenital anomalies code 740-759 CIE9-MC, were selected from the MBDS, in addition to a random sample of children under the age of 1 year without these discharge codes. Having reviewed the clinical documentation, the cases were classified as true positives and negatives and false positives and negatives. Positive and negative predictive value and sensitivity were calculated. The kappa test was applied to analyse diagnostic consistency between the MBDS and the clinical documentation.
Results:
A total of 2305 discharges of 1651 patients were identified. 4 out of the 5434 patients sampled had a major congenital abnormality. The positive predictive value was 56.4% (95% confidence interval [95%CI]: 53.9-58.8) and the negative predictive value was 99.3% (95%CI: 98.6-100.0). MBDS sensitivity was 68.6% (95%CI: 66.1-71.1). The most common codes in the true positives were: 745.5 (atrial septal defect), 745.4 (ventricular septal defect) and 747.0 (patent ductus arteriosus) and in the false positives: 747.0, 745.5 and 752.51 (cryptorchidism). 25.5% of diagnoses with congenital anomaly from the MBDS were not in the clinical documentation. Considering all diagnoses coded in the MBDS, the correlation was 0.70 (95%CI: 0.68-0.72) CONCLUSIONS: The MBDS is the main source of information to detect cases in the registry of congenital anomalies of the Valencian Community. Its main limitation is the high number of false positive cases detected.
