title: Birth defects surveillance: assessing the "gold standard".
abstract: OBJECTIVE
  This study assessed the sensitivity of the Metropolitan Atlanta Congenital Defects Program (MACDP) by capitalizing on the delayed receipt of a data source.
  
  
  METHODS
  In 1997, we reviewed the medical records of potential cases from the 1995 birth certificates that had not previously been identified by the MACDP. Capture-recapture methods produced an estimate of total cases.
  
  
  RESULTS
  We identified 1149 infants with defects, including 20 exclusively from birth certificates. The estimated sensitivity of the MACDP when data from birth certificates were included was 86.9% (95% confidence interval [CI] = 80.6%, 91.9%) at 1 year after birth, increasing to 94.8% (95% CI = 90.3%, 97.8%) at 2 years after birth.
  
  
  CONCLUSIONS
  The MACDP underestimates defects by 13% at 1 year after birth and by 5% at 2 years after birth.
authors.affiliation: Division of Birth Defects and Pediatric Genetics, Centers for Disease Control and Prevention, Atlanta, Ga 30341-7724, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Honein
authors.forename: L J
authors.initials: LJ
authors.lastname: Paulozzi
mesh_terms: D001719:Birth Certificates; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D011159:Population Surveillance / Q000379:methods*; D012042:Registries / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity