Birth defects surveillance: Assessing the "gold standard"

Objectives. This study assessed the sensitivity of tbe Metropolitan Atlanta Congenital Defects Program (MACDP) by capitalizing on the delayed receipt of a data source. Methods. In 1997, we reviewed the medical records of potential eases from the 1995 birth certificates that had not previously been identified by the MACDP. Capture meth ods produced an estimate of total cases. Results. We identified 1149 infants with defects, including 20 exclusively from birth cv:certificates. The estimated sensitivity of the MACDP when data. fram birth certificates were included tvas 86.9% (95% confidence Interval [CI] = 80.6%, 91.9%) at 1 year after birth, increasing to 94.8% (95% CI= 90.3%, 97.5%) at 2 years after birth. Conclusions. The MACDP under-estimates defects by 13% at 1 year after birth and by 5% at 2 years after birth.