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about better outcomes registry and network (BORN) data

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  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

SOURCE

Original Source: Better Outcomes Registry and Network (BORN) Ontario
Cite as:

  • For data obtained from the BORN-Niday database (prior to April 1, 2012):
    BORN Niday [years], BORN Ontario
  • For data extracted from the BORN Information System (after April 1, 2012):
    BORN Information System [years], BORN Ontario [extracted: {date}]

GENERAL INFORMATION ABOUT BORN

  • BORN data include detailed information on maternal, infant and perinatal care characteristics.
  • As of April 1, 2012, birthing hospitals and midwifery practices in Ontario contribute data to the BORN system. Prenatal screening labs, specialized antenatal clinics, newborn screening laboratories, prenatal and newborn screening follow-up clinics, and fertility clinics also provide data.
  • The content and the mechanism for accessing data have changed significantly over the years.
  • Prior to 2010, public health units were able to download record-level data regarding the births which occurred within their region for analysis through a web-based system. A four-year dataset (2005-2008) was provided to Peel Public Health in 2010 for analysis.
  • In 2010, the former Ontario Perinatal Surveillance System was granted registry status and was renamed the Better Outcomes Registry and Network (BORN). The five founding members of BORN (Ontario Maternal Multiple Marker Screening, Fetal Alert Network, Ontario Midwifery Program, Niday Perinatal Database and Ontario Newborn Screening) subsequently integrated their data into one maternal-child registry.
  • On April 1, 2012, the BORN Information System (BIS) went live. The web-based system provides three standard summary reports: birth, newborn, and pregnancy. These aggregate reports include rates, tables and graphs for various pre-defined indicators by health unit, peer group (not applicable for Peel) as well as for Ontario.
  • Some health units also have access to analytic cubes, which provide the ability to create customized reports (pivot tables) of real-time aggregate BORN data for a subset of the variables collected. Data are available in the cube from April 1, 2012 to present.
  • BORN data completeness and quality has improved over time.

METHODS

Data Collection Methods

  • Hospitals and midwives enter their own data into the BORN database either through direct data entry by health care staff (including nurses and clerks) or through a manual electronic retrieval from the hospital database
  • BORN data are reviewed and cleaned by BORN Ontario staff and maternal geographic information (e.g., maternal Public Health Unit (PHU)) is coded in the record based on postal code and city or town of residence using the postal code conversion files (PCCF+) files.
    • For cases where the postal code is either missing or invalid, the city/town of residence and/or first three digits of postal code (Forward Sortation Area (FSA)) used to assign PHU
    • If the postal code provided is not valid, the FSA will be missing within the dataset (although the maternal PHU will be assigned based on the city/town and/or FSA)
  • Niday data downloaded from the Niday web-site (prior to 2010) have not been reviewed and cleaned to the same degree as the BORN-Niday 2005-2008 dataset provided by BORN in 2010. Therefore there may be differences in the number of births and other analyses previously provided.

Analytical Methods

  • Compared to the previous datasets downloaded from the web-site there are some notable changes in the availability of data.
  • As of the 2005 dataset provided by BORN, the 6-digit postal code, exact birth weight in grams, and gestational age in completed weeks were not provided in order to address privacy concerns and to avoid the possible identification of individuals.
  • For mapping purposes, BORN data for key indicators must be aggregated to data zones based on postal code by BORN Ontario staff.
  • Rates and proportions based on counts less than six (6) are suppressed and presented in tables or graphs with the acronym 'NR' not releasable due to small numbers.
  • In order to estimate the annual number of live births which would be expected to occur, an average age-specific fertility rate was calculated based on BORN data for the period 2005 to 2010. These average age-specific fertility rates were multiplied by the projected female population within each of the age groups for 2015 to 2020 to calculate the expected number of births each year. The number of births was rounded to the nearest five births.

LIMITATIONS

  • Outside of a special request, only Peel data are available for analysis in the analytic cube
  • For some variables, the number of missing or unknown responses can be quite high.
  • As the data are entered by hospital staff or retrieved from the hospital's database electronically, estimates may be an under-representation of the true prevalence of the occurrence in the population.
  • For some variables (e.g., smoking during pregnancy, intention to breastfeed) some women may provide the socially desirable response to avoid perceived negative consequences or feelings of being judged by their health care provider.
  • Because of the changes in availability as well as definition of some variables over time, it is not always possible to observe trends over time.
  • Due to privacy concerns, the reduced level of detail of the data provided does not allow for certain analyses to be conducted (e.g. birth weight distribution).
  • There are only a limited number of demographic variables available within the BORN data. For example, information related to maternal ethnicity, income or education is not included. Therefore only ecological analyses of BORN-Niday data and demographic data from other data sources (e.g., census information) are possible.
  • Prior to 2007, Headwaters hospital in Orangeville did not participate in Niday and Peel mothers who delivered there were not captured. Therefore the number of births to Peel mothers prior to 2007 may have been an underestimate of the true number of births.


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