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Published on: November 22, 2019
The computerized perinatal database: are the data reliable?
D T Costakos1, L A Love, R S Kirby
1Franciscan Skemp Healthcare (Mayo Health System), Department of Pediatrics, LaCrosse, Wisconsin 54601, USA. costakos.dennis@mayo.edu
Insights
The PC-Log computerized perinatal database shows good agreement for many clinical variables, but has limitations for others like maternal ethanol use. Data accuracy is crucial for electronic birth certificates.
Area of Science:
- Perinatal medicine
- Health informatics
- Clinical data management
Background:
- Computerized perinatal databases are essential for electronic birth certificate transmission.
- Assessing the accuracy of clinical data in these systems is vital for reliable healthcare information.
- The PC-Log system is utilized in Wisconsin for perinatal data collection.
Purpose of the Study:
- To evaluate the clinical data accuracy of the PC-Log computerized perinatal database.
- To compare data in PC-Log against paper medical records for correctness.
- To identify specific variables with high and low agreement in the database.
Main Methods:
- A random sample of 99 charts was selected from 893 births at a tertiary perinatal center.
- 32 key variables from the PC-Log database were compared to hand-abstracted data from paper medical records.
- Positive-predictive value (PPV), sensitivity, and specificity were calculated for various clinical variables.
Main Results:
- PC-Log demonstrated 100% PPV for eclampsia, prolonged rupture of membranes, pre-existing diabetes, cesarean section, and transports.
- Moderate to high agreement was observed for variables including abortion, congenital anomalies, gestational diabetes, maternal hypertension, and maternal employment.
- Poor agreement was noted for maternal ethanol use, and PC-Log lacked data on substance abuse and length of stay.
Conclusions:
- The PC-Log system exhibits good agreement for many clinical variables, supporting its use in perinatal data collection.
- Limitations exist for certain variables, necessitating careful review and potential improvements in data abstraction.
- While birth weight and Apgar scores showed strong correlation, the database requires further validation for comprehensive clinical accuracy.
Abstract:
The purpose of this study is to examine the correctness of the clinical data from the computerized perinatal database (PC-Log) at a Mayo Health System hospital. This computerized database is used for electronic transmission of birth certificates in Wisconsin. The paper medical record is chosen for the comparison. Random selection of 99 charts from a total of 893 births at a tertiary perinatal center during 1995. Of 310 fields in the database, 32 variables were compared to a hand abstraction of the paper medical record. PC-Log had 100% positive-predictive value (PPV) for eclampsia, prolonged rupture of membranes, pre-existing diabetes, cesarean section, and transports. The sensitivity, specificity, and PPV for other variables (abortion, congenital anomalies, gestational diabetes, maternal hypertension, and maternal employment) showed moderate to high agreement, but was poor for maternal ethanol use during pregnancy. Compared to hand abstraction, PC-Log had no recorded cases of substance abuse, antenatal steroids, hyaline membrane disease, circumcision, maternal and infant length of stay. Means for birth weight 5 minute Apgar scores did not differ, and the correlations were r = 0.982 and r = 0.960. The PC-Log showed good agreement for many but not all the variables of clinical interest.
