Development of an algorithm to identify pregnancy episodes in an integrated health care delivery system.
OBJECTIVE
To develop and validate a software algorithm to detect pregnancy episodes and maternal morbidities using automated data.


METHODS
Automated records from a large integrated health care delivery system (IHDS), 1998-2001.


METHODS
Through complex linkages of multiple automated information sources, the algorithm estimated pregnancy histories. We evaluated the algorithm's accuracy by comparing selected elements of the pregnancy history obtained by the algorithm with the same elements manually abstracted from medical records by trained research staff.


METHODS
The algorithm searched for potential pregnancy indicators within diagnosis and procedure codes, as well as laboratory tests, pharmacy dispensings, and imaging procedures associated with pregnancy.


RESULTS
Among 32,847 women with potential pregnancy indicators, we identified 24,680 pregnancies occuring to 21,001 women. Percent agreement between the algorithm and medical records review on pregnancy outcome, gestational age, and pregnancy outcome date ranged from 91 percent to 98 percent. The validation results were used to refine the algorithm.


CONCLUSIONS
This pregnancy episode grouper algorithm takes advantage of databases readily available in IHDS, and has important applications for health system management and clinical care. It can be used in other settings for ongoing surveillance and research on pregnancy outcomes, pregnancy-related morbidities, costs, and care patterns.
Hornbrook
Mark C
MC
The Center for Health Research, Northwest/Hawaii/Southeast, 3800 N. Interstate Avenue, Portland, OR 97227-1110, USA.
Whitlock
Evelyn P
EP
Berg
Cynthia J
CJ
Callaghan
William M
WM
Bachman
Donald J
DJ
Gold
Rachel
R
Bruce
F Carol
FC
Dietz
Patricia M
PM
Williams
Selvi B
SB
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D005865:Gestational Age; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012985:Software Design; D012986:Software Validation