Utility of Electronic Case Reporting for Case Identification in Texas Birth Defects Surveillance

Area of Science:

• Public Health
• Epidemiology
• Health Informatics

Background:

• The effectiveness of electronic case reporting (eCR) for birth defects surveillance remains largely unexamined.
• This study evaluates the potential of electronic initial case reports (eICRs) as a source for case identification and compares their data completeness against electronic health records (EHRs).

Purpose of the Study:

• To assess the utility of eCR for birth defects surveillance.
• To compare the demographic and diagnostic information captured by eICRs versus EHRs.

Main Methods:

• Birth defect cases were identified from the Texas Birth Defects Registry's eCR data stream.
• Data from eICRs and subsequently abstracted EHRs were compared for completeness and concordance.
• Weighted kappa statistics were used to evaluate agreement between the two data sources for various variables.

Main Results:

• eICRs exhibited significant data deficiencies, reporting fewer birth defects and procedures compared to EHRs.
• Concordance between eICRs and EHRs was low for most variables, with notable exceptions including infant sex, birthdate, and primary defect diagnosis.
• High agreement was observed for infant sex (kappa=0.95), birthdate (kappa=0.99), and primary defect codes (kappa=0.83-0.92).

Conclusions:

• eCR offers a potential pathway for timely identification of potential birth defect cases and facilitates prompt social service referrals.
• Standardization issues and missing critical variables in eCR data files limit their comprehensiveness for risk factor analysis.
• While promising for initial case identification, eCR is not yet a comprehensive data resource for all aspects of birth defect surveillance.