title: Birth of identity: understanding changes to birth certificates and their value for identity resolution.
abstract: BACKGROUND
  Identity information is often used to link records within or among information systems in public health and clinical settings. The quality and stability of birth certificate identifiers impacts both the success of linkage efforts and the value of birth certificate registries for identity resolution.
  
  
  OBJECTIVE
  Our objectives were to describe: (1) the frequency and cause of changes to birth certificate identifiers as children age, and (2) the frequency of events (ie, adoptions, paternities, amendments) that may trigger changes and their impact on names.
  
  
  METHODS
  We obtained two de-identified datasets from the Utah birth certificate registry: (1) change history from 2000 to 2012, and (2) occurrences for adoptions, paternities, and amendments among births in 1987 and 2000. We conducted cohort analyses for births in 1987 and 2000, examining the number, reason, and extent of changes over time. We conducted cross-sectional analyses to assess the patterns of changes between 2000 and 2012.
  
  
  RESULTS
  In a cohort of 48 350 individuals born in 2000 in Utah, 3164 (6.5%) experienced a change in identifiers prior to their 13th birthday, with most changes occurring before 2 years of age. Cross-sectional analysis showed that identifiers are stable for individuals over 5 years of age, but patterns of changes fluctuate considerably over time, potentially due to policy and social factors.
  
  
  CONCLUSIONS
  Identities represented in birth certificates change over time. Specific events that cause changes to birth certificates also fluctuate over time. Understanding these changes can help in the development of automated strategies to improve identity resolution.
authors: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors: Jeffrey
authors: J
authors: Duncan
authors: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA Intermountain Healthcare, Salt Lake City, Utah, USA.
authors: Scott P
authors: SP
authors: Narus
authors: Department of Computer Science, Utah State University, Logan, Utah, USA.
authors: Stephen
authors: S
authors: Clyde
authors: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors: Karen
authors: K
authors: Eilbeck
authors: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA Intermountain Healthcare, Salt Lake City, Utah, USA.
authors: Sidney
authors: S
authors: Thornton
authors: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors: Catherine
authors: C
authors: Staes
mesh_terms: D000293:Adolescent; D000300:Adoption / Q000331:legislation & jurisprudence; D001719:Birth Certificates / Q000331:legislation & jurisprudence; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008498:Medical Record Linkage; D010334:Paternity; D014589:Utah
keywords: birth certificates; medical record linkage; public health