{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:33:00Z","timestamp":1787225580627,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009898","name":"Defense Health Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009898","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Department of Defense Birth and Infant Health Research program is dedicated to birth defects research and surveillance among military families. Here, we assess and refine the validity of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD\u20109\u2010CM) codes for selected genitourinary birth defects in the Military Health System (MHS). We additionally outline methods for the calculation of positive predictive value (PPV) and negative predictive value (NPV), sensitivity, and specificity using a stratified sampling design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among military infants born from 2006 through 2014, a random sample of ICD\u20109\u2010CM screen\u2010positive cases (for six genitourinary birth defects) and screen\u2010negative cases were selected for chart review. PPV, NPV, sensitivity, and specificity were calculated for individual defects and any included defect (i.e., overall); measures were weighted by the inverse probability of being sampled.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 461,557 infants, 686 were sampled for chart review. Bladder exstrophy was accurately reported (PPV: &gt;90%), while the accuracy of renal dysplasia, renal agenesis\/hypoplasia, and hypospadias was moderate (PPVs: 66%\u201368%) and congenital hydronephrosis was low (PPV: 20%). Specificity and NPVs always exceeded 98%. The overall PPV was 50%; however, excluding congenital hydronephrosis screen\u2010positive cases and requiring at least two inpatient or outpatient diagnostic codes resulted in a PPV of 85%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The validity of major genitourinary birth defect codes varied in MHS administrative data. The accuracy of an overall defect measure improved by omitting congenital hydronephrosis and requiring at least two diagnostic codes. Although PPV is generally useful for research, additional calculation of NPV, sensitivity, and specificity better informs the identification of appropriate selection criteria across surveillance and research settings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2265","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T11:14:25Z","timestamp":1699355665000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Validation of <scp>ICD\u20109\u2010CM<\/scp> codes for major genitourinary birth defects in Military Health System administrative data, 2006\u20132014"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7798-5333","authenticated-orcid":false,"given":"Celeste J.","family":"Romano","sequence":"first","affiliation":[{"name":"Deployment Health Research Department, Naval Health Research Center  San Diego California USA"},{"name":"Leidos, Inc., San Diego  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra M.","family":"Magallon","sequence":"additional","affiliation":[{"name":"Deployment Health Research Department, Naval Health Research Center  San Diego California USA"},{"name":"Leidos, Inc., San Diego  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-1000","authenticated-orcid":false,"given":"Clinton","family":"Hall","sequence":"additional","affiliation":[{"name":"Deployment Health Research Department, Naval Health Research Center  San Diego California USA"},{"name":"Leidos, Inc., San Diego  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna T.","family":"Bukowinski","sequence":"additional","affiliation":[{"name":"Deployment Health Research Department, Naval Health Research Center  San Diego California USA"},{"name":"Leidos, Inc., San Diego  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gia R.","family":"Gumbs","sequence":"additional","affiliation":[{"name":"Deployment Health Research Department, Naval Health Research Center  San Diego California USA"},{"name":"Leidos, Inc., San Diego  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4007-3330","authenticated-orcid":false,"given":"Ava Marie S.","family":"Conlin","sequence":"additional","affiliation":[{"name":"Deployment Health Research Department, Naval Health Research Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2022.10.007"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.10.006"},{"issue":"11","key":"e_1_2_8_4_1","first-page":"39","article-title":"Department of Defense Birth and Infant Health Registry: Select reproductive health outcomes, 2003\u20132014","volume":"24","author":"Bukowinski A. 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(2019).Genital and urinary tract defects.https:\/\/www.marchofdimes.org\/find\u2010support\/topics\/planning\u2010baby\/genital\u2010and\u2010urinary\u2010tract\u2010defects"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-012-2107-y"},{"issue":"9","key":"e_1_2_8_20_1","article-title":"Congenital anomalies of the kidney and urinary tract in preterm infants\u2014Active drivers of increased disease or associated bystanders?","volume":"5","author":"Mohamed T. H.","year":"2022","journal-title":"Journal of American Medical Association Network Open"},{"key":"e_1_2_8_21_1","unstructured":"National Birth Defects Prevention Network (NBDPN). (2015).NBDPN guidelines for conducting birth defects surveillance.https:\/\/www.nbdpn.org\/birth_defects_surveillance_gui.php#new"},{"key":"e_1_2_8_22_1","unstructured":"National Birth Defects Prevention Network (NBDPN). (2022).Major birth defects data from population\u2010based birth defects surveillance programs in the United States 2014\u20132018.https:\/\/www.nbdpn.org\/docs\/Birth_Defects_Data_and_Directory_2022.pdf"},{"key":"e_1_2_8_23_1","unstructured":"National Birth Defects Prevention Network (NBDPN). (2023).ICD\u201010\u2010CM and birth defects. 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