ENHANCING THE CLASSIFICATION OF CONGENITAL HEART DEFECTS FOR OUTCOME ASSOCIATION STUDIES IN BIRTH DEFECTS REGISTRIES

Details

• Alternative Title:
  Birth Defects Res
• Personal Author:
  Stephens, Sara B. ; Benjamin, Renata H. ; Lopez, Keila N. ; Anderson, Brett R. ; Lin, Angela E. ; Shumate, Charles J. ; Nembhard, Wendy N. ; Morris, Shaine A. ; Agopian, A.J.
• Description:
  Introduction:
  
  Traditional strategies for grouping congenital heart defects (CHDs) using birth defect registry data do not adequately address differences in expected clinical consequences between different combinations of CHDs. We report a lesion-specific classification system for birth defect registry-based outcome studies.
  
  Methods:
  
  For Core Cardiac Lesion Outcome Classifications (C-CLOC) groups, common CHDs expected to have reasonable clinical homogeneity were defined. Criteria based on combinations of Centers for Disease and Control-modified British Pediatric Association (BPA) codes were defined for each C-CLOC group. To demonstrate proof of concept and retention of reasonable case counts within C-CLOC groups, Texas Birth Defect Registry data (1999–2017 deliveries) were used to compare case counts and neonatal mortality between traditional versus C-CLOC classification approaches.
  
  Results:
  
  C-CLOC defined 59 CHD groups among 62,262 infants with CHDs. Classifying cases into the single, mutually exclusive C-CLOC group reflecting the highest complexity CHD present reduced case counts among lower complexity lesions (e.g., 86.5% of cases with a common atrium BPA code were reclassified to a higher complexity group for a co-occurring CHD). As expected, C-CLOC groups had retained larger sample sizes (i.e., representing presumably better-powered analytic groups) compared to cases with only one CHD code and no occurring CHDs.
  
  Discussion:
  
  This new CHD classification system for investigators using birth defect registry data, C-CLOC, is expected to balance clinical outcome homogeneity in analytic groups while maintaining sufficiently large case counts within categories, thus improving power for CHD-specific outcome association comparisons. Future outcome studies utilizing C-CLOC-based classifications are planned.
  
  
• Subjects:
  Congenital Abnormalities Female Heart Defects, Congenital Humans Infant Infant, Newborn Infant Mortality Male Outcome Assessment, Health Care Registries Texas

  More +
• Keywords:
  Birth Defect Registry Classification Congenital Anomalies Congenital Heart Defects Surveillance Programs
• Source:
  Birth Defects Res. 116(8):e2393
• Pubmed ID:
  39169811
• Pubmed Central ID:
  PMC11421657
• Document Type:
  Journal Article
• Funding:
  R01 HD093660/HD/NICHD NIH HHSUnited States/ ; HRSA/HRSA HHSUnited States/ ; NU50DD000102/Texas Department of State Health Services/ ; HHS 00096260001/Texas Department of State Health Services/ ; CC/CDC HHSUnited States/
• Volume:
  116
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b5e76618fad97c3b4b4ba95e64ee50964f150dba0d8c96514e4bbc2d7826633c88c99693a0dc9f8f40b2885a5d17d659828c2d0dd331811df4518a74b50da4bf
• Download URL:
  https://stacks.cdc.gov/view/cdc/162461/cdc_162461_DS1.pdf
• File Type:
  [PDF - 1.00 MB ]