Development and validation of an algorithm to predict stillbirth gestational age in Medicaid billing records.
With Medicaid covering half of US pregnancies, Medicaid Analytic eXtract (MAX) provides a valuable data source to enrich understanding about stillbirth etiologies. We developed and validated a claims-based algorithm to predict gestational age (GA) at stillbirth. We linked the stillbirths identified...
| Publicado en: | American Journal of Epidemiology Vol. 194; no. 8; pp. 2295 - 2304 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Aug2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188027727&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188027727 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00029262 1X1 jtl: American Journal of Epidemiology issn: 00029262 maglogo: N pubinfo: dt: Aug2025 vid: 194 iid: 8 pid: 622 pub: Oxford University Press / USA artinfo: ui: 188027727 188027727 188027727 10.1093/aje/kwae369 188027727 ppf: 2295 ppct: 9 formats: tig: atl: Development and validation of an algorithm to predict stillbirth gestational age in Medicaid billing records. aug: au: Thai, Thuy N Smolinski, Nicole E Nduaguba, Sabina Zhu, Yanmin Bird, Steven Straub, Loreen Bateman, Brian T Hernández-Díaz, Sonia Huybrechts, Krista F Rasmussen, Sonja A Winterstein, Almut G affil: Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, United States sug: subj: Algorithms Instrument Construction Instrument Validation Perinatal Death Gestational Age Prediction Models Medicaid Billing and Claims Funding Source Human Validation Studies International Classification of Diseases Female Adolescence Adult Middle Age Confidence Intervals Descriptive Statistics Linear Regression Bivariate Statistics Random Forest Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Female ab: With Medicaid covering half of US pregnancies, Medicaid Analytic eXtract (MAX) provides a valuable data source to enrich understanding about stillbirth etiologies. We developed and validated a claims-based algorithm to predict gestational age (GA) at stillbirth. We linked the stillbirths identified in MAX 1999-2013 to Florida fetal death records (FDRs) to obtain clinical estimates of GA (n = 825). We tested several algorithms, including using a fixed median GA, median GA at the time of specific prenatal screening tests, and expanded versions considering additional predictors of stillbirth, including linear regression and random forest models. We estimated the proportion of pregnancies with differences of ±1, 2, 3 and 4 weeks between the predicted and FDR GA and the model mean square error (MSE). We validated the selected algorithms in 2 external samples. The best performing algorithm was a random forest model (MSE, 12.67 weeks2) with 84% of GAs within ±4 weeks. Assigning a fixed GA of 28 weeks resulted in an MSE of 60.21 weeks2 and proportions of GA within ±4 weeks of 32%. We observed consistent results in the external samples. Our prediction algorithm for stillbirths can facilitate pregnancy research in the Medicaid population. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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