Table 1.
Observational data source descriptions.
Fig 1.
Illustration of steps performed by pregnancy episode algorithm for sample patient with three classified pregnancy episodes and estimated start dates.
LB: Live birth; SB: Stillbirth; ECT: Ectopic pregnancy; SA: Abortion; PCONF: Pregnancy confirmation marker; ULS: Nuchal ultrasound; AMEN: Amenorrhea record.
Fig 2.
Distribution of pregnancy algorithm start estimation method groups for all pregnancy episodes from each data source (CPRD, Optum, Truven CCAE, and Truven MDCD) by outcome (abortion, ectopic pregnancy, live birth, and stillbirth).
Legend for start estimation methods in stacked bars: Group 1 = last menstrual period, gestational age record, fertility procedure; Group 2 = alpha-fetoprotein test, nuchal ultrasound; Group 3 = amenorrhea record, urine pregnancy test record; Group 4 = average gestational age estimate.
Fig 3.
Distribution of duration of all pregnancy episodes, with episode lengths shown in 10 day increments for live births, stratified by method of pregnancy start estimation and data source (CPRD, Optum, Truven CCAE, and Truven MDCD).
Legend for start estimation methods referenced in row panels:
LMP = last menstrual period
GEST = gestational age record
INFERT = fertility procedure
ULS = nuchal ultrasound
AFP = alpha-fetoprotein test
AMEN = amenorrhea record
URINE = urine pregnancy record
AVG = gestational age estimate
ALL = all start estimation methods combined.
Fig 4.
Performance rating for five operating characteristics of algorithm (survey questions 1,2,4–6) from electronic profile review survey.
Fig 5.
The distribution of reviewer estimated pregnancy start difference in days from the algorithm start (< -14, -8 thru -14, -1 thru -7, 0, 1 through 7, 8 through 14 and > 14 days) in the Optum database, stratified by pregnancy outcome (all outcomes, live birth, abortion, ectopic pregnancy, and stillbirth) and method used for pregnancy start estimation.
Legend for start estimation methods referenced in row panels:
LMP = last menstrual period
GEST = gestational age record
INFERT = fertility procedure
ULS = nuchal ultrasound
AFP = alpha-fetoprotein test
AMEN = amenorrhea record
URINE = urine pregnancy record
AVG = average gestational age estimate
ALL = all start estimation methods combined
*If percentages do not add up to 100%, reviewer indicated difference in days from the algorithm could not be determined.
Fig 6.
The distribution of reviewer estimated pregnancy start difference in days from the algorithm start (< -14, -8 thru -14, -1 thru -7, 0, 1 through 7, 8 through 14 and > 14 days) in the CPRD database, stratified by pregnancy outcome (all outcomes, live birth, abortion, ectopic pregnancy, and stillbirth) and method used for pregnancy start estimation.
Legend for start estimation methods referenced in row panels:
LMP = last menstrual period
GEST = gestational age record
INFERT = fertility procedure
ULS = nuchal ultrasound
AFP = alpha-fetoprotein test
AMEN = amenorrhea record
URINE = urine pregnancy record
AVG = average gestational age estimate
ALL = all start estimation methods combined
*If percentages do not add up to 100%, reviewer indicated difference in days from the algorithm could not be determined.
Table 2.
End of pregnancy episode date accuracy: Reviewer chosen date categorized by difference from algorithm derived date.
Table 3.
Optum validation sensitivity analysis: Algorithm chosen pregnancy start categorized by difference in either direction from infertility procedure derived start.