Decreasing Diagnoses of Birth Asphyxia in Canada: Fact or Artifact
Bibliographic record
Abstract
OBJECTIVE: We assessed temporal trends in birth asphyxia in Canada, to determine whether changes were real or secondary to changes in coding. METHODS: We used data from the Canadian Institute for Health Information Discharge Abstract Database to study the national incidence of birth asphyxia, by using International Classification of Diseases codes. We also studied birth asphyxia by using data from the Nova Scotia Atlee Perinatal Database. In the Nova Scotia Atlee Perinatal Database, we defined a case of birth asphyxia as a live birth with an Apgar score at 5 minutes of < or =3, depression at birth requiring resuscitation with a mask for > or =3 minutes and/or intubation, or neonatal postasphyctic seizures. RESULTS: Nationally, between 1991 and 2005, the incidence of birth asphyxia decreased significantly, from 43.8 to 2.4 cases per 1000 live births. The rate of decrease was highest between 1991 and 1998, corresponding to a period when strict Canadian and international criteria for the diagnosis of birth asphyxia were published. By comparison, neither national rates of related diagnoses nor Nova Scotia birth asphyxia rates, which ranged from 8.8 to 14.3 cases per 1000 live births, showed evidence of a decrease during the study period. CONCLUSIONS: Comparisons of national trends in birth asphyxia diagnoses and trends in conditions associated with birth asphyxia, both nationally and in Nova Scotia, suggest that the dramatic decrease in the diagnosis of birth asphyxia is an artifact of changes in the use of International Classification of Diseases coding associated with the publication of stricter diagnostic definitions of birth asphyxia. We conclude that International Classification of Diseases codes are not useful for surveillance of birth asphyxia.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".