National register data are of value in studies on miscarriage—Validation of the healthcare register data in Finland

Abstract Introduction Despite the high prevalence of miscarriages, they are not systematically registered and few epidemiological studies have been done. As Finnish health registries are comprehensive and widely used in research, we validated the Finnish register data concerning diagnostics and trea...

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Main Authors: Nea Helle, Maarit Niinimäki, Reetta Linnakaari, Anna But, Mika Gissler, Oskari Heikinheimo, Maarit Mentula
Format: Article
Language:English
Published: Wiley 2022-11-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14445
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author Nea Helle
Maarit Niinimäki
Reetta Linnakaari
Anna But
Mika Gissler
Oskari Heikinheimo
Maarit Mentula
author_facet Nea Helle
Maarit Niinimäki
Reetta Linnakaari
Anna But
Mika Gissler
Oskari Heikinheimo
Maarit Mentula
author_sort Nea Helle
collection DOAJ
description Abstract Introduction Despite the high prevalence of miscarriages, they are not systematically registered and few epidemiological studies have been done. As Finnish health registries are comprehensive and widely used in research, we validated the Finnish register data concerning diagnostics and treatment of miscarriage, and treatment‐related adverse events. Material and methods We conducted a validation study regarding miscarriage‐related codes of diagnoses and surgical procedures in a Finnish National Hospital Discharge Registry (NHDR) by comparing the information from the NHDR with that of the hospital records. We selected a random sample of 4 months during 1998–2016 from three hospitals, comprising 687 women aged 15–49 experiencing a first miscarriage during follow‐up. Women with diagnoses unrelated to miscarriage, or proven to be other than miscarriage, were excluded. The final sample consisted of 643 women with confirmed miscarriage, which was used for analyses regarding the diagnosis, treatment and adverse events of miscarriage treatment. Results The majority of miscarriages registered in the NHDR were confirmed by the hospital records (positive predictive value [PPV] = 93.6% [95% confidence interval [CI] 91.8%–95.4%]). Different types of miscarriage were also reliably identified; spontaneous abortion with PPV = 85.6% (95% CI 80.9%–89.2%), missed abortion with PPV = 92.7% (95% CI 88.8%–95.3%) and blighted ovum with PPV = 91.1% (95% CI 84.3%–95.1%). The PPV of surgical treatment (62.2% [95% CI 55.7%–68.3%]) was lower than the PPV of non‐surgical treatment (93.3% [95% CI 90.5%–95.3%]). The diagnoses regarding adverse events of miscarriage treatment could be reliably identified. The PPV for clinical infections was 76.0% (95% CI 56.6%–88.5%) and for retained products of conception or/and vaginal bleeding 96.8% (95% CI 83.8%–99.4%). Conclusions The coverage of the NHDR was good concerning identification of miscarriages, different types of miscarriages and non‐surgical treatment. Nevertheless, there is a need for clearly defined procedural codes concerning to medical treatment of miscarriage. The register‐based data are reliable and practicable for both clinical evaluation and research concerning miscarriage.
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spelling doaj-art-e51ad4deb5554ccd8ef1e1d0ed6a070f2025-08-20T03:30:56ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-11-01101111245125210.1111/aogs.14445National register data are of value in studies on miscarriage—Validation of the healthcare register data in FinlandNea Helle0Maarit Niinimäki1Reetta Linnakaari2Anna But3Mika Gissler4Oskari Heikinheimo5Maarit Mentula6Department of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital Helsinki FinlandDepartment of Obstetrics and Gynecology Oulu University Hospital Oulu FinlandDepartment of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital Helsinki FinlandDepartment of Biostatistics University of Helsinki Helsinki FinlandFinnish Institute for Health and Welfare (THL) Helsinki FinlandDepartment of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital Helsinki FinlandDepartment of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital Helsinki FinlandAbstract Introduction Despite the high prevalence of miscarriages, they are not systematically registered and few epidemiological studies have been done. As Finnish health registries are comprehensive and widely used in research, we validated the Finnish register data concerning diagnostics and treatment of miscarriage, and treatment‐related adverse events. Material and methods We conducted a validation study regarding miscarriage‐related codes of diagnoses and surgical procedures in a Finnish National Hospital Discharge Registry (NHDR) by comparing the information from the NHDR with that of the hospital records. We selected a random sample of 4 months during 1998–2016 from three hospitals, comprising 687 women aged 15–49 experiencing a first miscarriage during follow‐up. Women with diagnoses unrelated to miscarriage, or proven to be other than miscarriage, were excluded. The final sample consisted of 643 women with confirmed miscarriage, which was used for analyses regarding the diagnosis, treatment and adverse events of miscarriage treatment. Results The majority of miscarriages registered in the NHDR were confirmed by the hospital records (positive predictive value [PPV] = 93.6% [95% confidence interval [CI] 91.8%–95.4%]). Different types of miscarriage were also reliably identified; spontaneous abortion with PPV = 85.6% (95% CI 80.9%–89.2%), missed abortion with PPV = 92.7% (95% CI 88.8%–95.3%) and blighted ovum with PPV = 91.1% (95% CI 84.3%–95.1%). The PPV of surgical treatment (62.2% [95% CI 55.7%–68.3%]) was lower than the PPV of non‐surgical treatment (93.3% [95% CI 90.5%–95.3%]). The diagnoses regarding adverse events of miscarriage treatment could be reliably identified. The PPV for clinical infections was 76.0% (95% CI 56.6%–88.5%) and for retained products of conception or/and vaginal bleeding 96.8% (95% CI 83.8%–99.4%). Conclusions The coverage of the NHDR was good concerning identification of miscarriages, different types of miscarriages and non‐surgical treatment. Nevertheless, there is a need for clearly defined procedural codes concerning to medical treatment of miscarriage. The register‐based data are reliable and practicable for both clinical evaluation and research concerning miscarriage.https://doi.org/10.1111/aogs.14445blighted ovumcoveragemiscarriagemissed abortionspontaneous abortiontreatment of miscarriage
spellingShingle Nea Helle
Maarit Niinimäki
Reetta Linnakaari
Anna But
Mika Gissler
Oskari Heikinheimo
Maarit Mentula
National register data are of value in studies on miscarriage—Validation of the healthcare register data in Finland
Acta Obstetricia et Gynecologica Scandinavica
blighted ovum
coverage
miscarriage
missed abortion
spontaneous abortion
treatment of miscarriage
title National register data are of value in studies on miscarriage—Validation of the healthcare register data in Finland
title_full National register data are of value in studies on miscarriage—Validation of the healthcare register data in Finland
title_fullStr National register data are of value in studies on miscarriage—Validation of the healthcare register data in Finland
title_full_unstemmed National register data are of value in studies on miscarriage—Validation of the healthcare register data in Finland
title_short National register data are of value in studies on miscarriage—Validation of the healthcare register data in Finland
title_sort national register data are of value in studies on miscarriage validation of the healthcare register data in finland
topic blighted ovum
coverage
miscarriage
missed abortion
spontaneous abortion
treatment of miscarriage
url https://doi.org/10.1111/aogs.14445
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AT reettalinnakaari nationalregisterdataareofvalueinstudiesonmiscarriagevalidationofthehealthcareregisterdatainfinland
AT annabut nationalregisterdataareofvalueinstudiesonmiscarriagevalidationofthehealthcareregisterdatainfinland
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