title: Intraclass correlation coefficients in the Brazilian Network for Surveillance of Severe Maternal Morbidity study.
abstract: BACKGROUND
  The purpose of the study was to evaluate intraclass correlation coefficients (ICC) of variables concerning personal characteristics, structure, outcome and process in the Brazilian Network for Surveillance of Severe Maternal Morbidity study conducted to identify severe maternal morbidity/near miss cases using the World Health Organization criteria.
  
  
  METHODS
  It was a cross-sectional, multicenter study involving 27 hospitals providing care for pregnant women in Brazil. Cluster size and the mean size of the primary sampling unit were described. Estimated prevalence rates, ICC, their respective 95% confidence intervals, the design effect and the mean cluster size were presented for each variable.
  
  
  RESULTS
  Overall, 9,555 cases of severe maternal morbidity (woman admitted with potentially life-threatening conditions, near miss events or death) were included in the study. ICC ranged from < 0.001 to 0.508, with a median of 0.035. ICC was < 0.1 for approximately 75% of the variables. For process-related variables, median ICC was 0.09, with 0.021 for those related to outcome. These findings confirm data from previous studies. Homogeneity may be considered minor, thus increasing reliability of these findings.
  
  
  CONCLUSIONS
  These results may be used to design new cluster trials in maternal and perinatal health and to help calculate sample sizes.
authors.affiliation: Department of Obstetrics & Gynecology, University of Campinas, Campinas, Brazil.
authors.forename: Samira M
authors.initials: SM
authors.lastname: Haddad
authors.forename: Maria H
authors.initials: MH
authors.lastname: Sousa
authors.forename: Jose G
authors.initials: JG
authors.lastname: Cecatti
authors.forename: Mary A
authors.initials: MA
authors.lastname: Parpinelli
authors.forename: Maria L
authors.initials: ML
authors.lastname: Costa
authors.forename: Joao P
authors.initials: JP
authors.lastname: Souza
mesh_terms: D001938:Brazil; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D018401:Sample Size