Last data update: Jul 01, 2024. (Total: 47134 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Clark EA [original query] |
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Identification of pregnancies and their outcomes in healthcare claims data, 2008-2019: An algorithm
Ailes EC , Zhu W , Clark EA , Huang YA , Lampe MA , Kourtis AP , Reefhuis J , Hoover KW . PLoS One 2023 18 (4) e0284893 Pregnancy is a condition of broad interest across many medical and health services research domains, but one not easily identified in healthcare claims data. Our objective was to establish an algorithm to identify pregnant women and their pregnancies in claims data. We identified pregnancy-related diagnosis, procedure, and diagnosis-related group codes, accounting for the transition to International Statistical Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis and procedure codes, in health encounter reporting on 10/1/2015. We selected women in Merative MarketScan commercial databases aged 15-49 years with pregnancy-related claims, and their infants, during 2008-2019. Pregnancies, pregnancy outcomes, and gestational ages were assigned using the constellation of service dates, code types, pregnancy outcomes, and linkage to infant records. We describe pregnancy outcomes and gestational ages, as well as maternal age, census region, and health plan type. In a sensitivity analysis, we compared our algorithm-assigned date of last menstrual period (LMP) to fertility procedure-based LMP (date of procedure + 14 days) among women with embryo transfer or insemination procedures. Among 5,812,699 identified pregnancies, most (77.9%) were livebirths, followed by spontaneous abortions (16.2%); 3,274,353 (72.2%) livebirths could be linked to infants. Most pregnancies were among women 25-34 years (59.1%), living in the South (39.1%) and Midwest (22.4%), with large employer-sponsored insurance (52.0%). Outcome distributions were similar across ICD-9 and ICD-10 eras, with some variation in gestational age distribution observed. Sensitivity analyses supported our algorithm's framework; algorithm- and fertility procedure-derived LMP estimates were within a week of each other (mean difference: -4 days [IQR: -13 to 6 days]; n = 107,870). We have developed an algorithm to identify pregnancies, their gestational age, and outcomes, across ICD-9 and ICD-10 eras using administrative data. This algorithm may be useful to reproductive health researchers investigating a broad range of pregnancy and infant outcomes. |
Contraception recommendations: Updates for the busy clinician
Clark EA , Curtis KM . Am Fam Physician 2022 106 (3) 227-228 Primary care clinicians are an important source of reproductive health care,1 but it can be challenging for busy clinicians to keep up with new developments. The U.S. Food and Drug Administration continues to approve new contraceptive methods, and knowledge of these changes is essential to informed patient-centered decision-making. One way for clinicians to stay up-to-date on new evidence regarding contraception safety and administration is to use point-of-care tools that summarize evidence-based recommendations. For example, the Centers for Disease Control and Prevention (CDC) has developed a free smartphone application (https://www.cdc.gov/reproductivehealth/contraception/contraception-app.html) that summarizes guidelines from the U.S. Medical Eligibility Criteria for Contraceptive Use (USMEC) and the U.S. Selected Practice Recommendations for Contraceptive Use (USSPR).2,3 These tools are easy to use and allow the clinician to incorporate evidence into counseling. |
Update to U.S. Selected Practice Recommendations for Contraceptive Use: Self-Administration of Subcutaneous Depot Medroxyprogesterone Acetate
Curtis KM , Nguyen A , Reeves JA , Clark EA , Folger SG , Whiteman MK . MMWR Morb Mortal Wkly Rep 2021 70 (20) 739-743 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR), adapted by CDC from global guidance developed by the World Health Organization (WHO), provides evidence-based guidance on contraceptive use for U.S. health care providers (1). During January-February, 2021, CDC evaluated the 2019 WHO recommendation on self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC) (2). CDC adopted the WHO recommendation on the basis of moderate-certainty evidence that self-administered DMPA-SC is safe and effective, and has higher continuation rates compared with provider-administered DMPA. The new U.S. SPR recommendation states that self-administered DMPA-SC should be made available as an additional approach to deliver injectable contraception. Provider-administered DMPA should remain available. Self-administered DMPA-SC is a user-controlled method that has the potential to improve contraceptive access and increase reproductive autonomy. Self-administered DMPA-SC should be offered in a noncoercive manner through a shared decision-making process between patients and their health care providers, with a focus on patient preferences and equitable access to the full range of contraceptive methods. |
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