Related Experiment Video
Updated: Jun 3, 2025
Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Evaluating an ICD-10 Based Proxy for Date of Birth in Electronic Health Record Data
Sara Burns1, Ariel Mueller2, Matthew Smith2
1Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.
Insights
A new method uses the date of a patient's first ICD-10-CM birth code as a proxy for date of birth in pediatric real-world data (RWD) studies, improving age granularity for research.
Area of Science:
- Health Informatics
- Pediatric Research
- Data Privacy
Background:
- Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule often masks patient dates of birth.
- Limited age granularity in real-world data (RWD) hinders pediatric research.
- Electronic health record (EHR) data is a valuable source for clinical insights.
Purpose of the Study:
- To evaluate a proxy for patient date of birth using EHR data.
- To address challenges in pediatric research due to masked birth dates in RWD.
- To assess the feasibility of using ICD-10-CM birth codes as a date of birth proxy.
Main Methods:
- Retrospective cohort study of EHR data from Mass General Brigham (MGB).
- Assessed International Classification of Diseases 10th Revision Clinical Modification (ICD-10-CM) birth codes (Z37*, Z38*) as a proxy.
- Evaluated alternative proxies like infancy-related codes and clinical activity dates.
Main Results:
- Included 58,047 of 82,398 patients (70.4%) with ICD-10-CM birth codes.
- Mean difference between true date of birth and proxy was 0.3 days (SD 15.0 days).
- 99.9% of proxies occurred within 30 days of the true date of birth.
Conclusions:
- The date of the first ICD-10-CM birth code serves as a reliable proxy for patient date of birth.
- This method enhances age granularity in pediatric RWD studies.
- Facilitates more robust analysis in pediatric clinical research.
Purpose:
To comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, many real-world data providers mask a patient's date of birth by supplying only year of birth to data users. The lack of granularity around patient age is a challenge when using RWD, especially for pediatric research studies. In this study, a proxy for patient date of birth is evaluated using electronic health record (EHR) data.
Methods:
This validation study leverages a retrospective cohort of EHR data from Mass General Brigham (MGB) patients born between January 1, 2018, and December 31, 2022, to assess the use of the date of a patient's first observed International Classification of Diseases 10th Revision Clinical Modification (ICD-10-CM) day-of birth code (Z37* or Z38*) as a proxy for date of birth. Alternative proxy measures such as date of first other infancy-related ICD-10-CM code and date of first clinical activity were also assessed.
Results:
Of 82 398 patients born during the five-year study period, 58 047 (70.4%) had an ICD-10-CM birth code and were included in the primary analysis. The mean difference between true date of birth and first observed birth code was 0.3 days with a standard deviation of 15.0 days. The first observed birth code occurred within 30 days of the true date of birth in 99.9% of cases.
Conclusion:
Results from this study suggest that the date of the first day-of ICD-10-CM birth code can be used as a proxy for true patient date of birth in pediatric RWD studies.
More Related Videos
Related Concept Videos
01:19Purpose of Health Records II
01:30Methods of Documentation VII: EMR
01:10Documentation of Nursing Diagnosis
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
01:23Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
01:20Actuarial Approach
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include: