A collaborative maternity and newborn dashboard (CoMaND) for the COVID-19 pandemic: a protocol for timely, adaptive monitoring of perinatal outcomes in Melbourne, Australia

  1. Lisa Hui
  2. Melvin Barrientos Marzan
  3. Stephanie Potenza
  4. Daniel L. Rolnik
  5. Joanne M. Said
  6. Kirsten R Palmer
  7. Clare L. Whitehead
  8. Penelope M. Sheehan
  9. Jolyon Ford
  10. Natasha Pritchard
  11. Ben W. Mol
  12. Susan P. Walker

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Abstract

Background

The COVID-19 pandemic has resulted in a range of unprecedented disruptions to the delivery of maternity care globally and has been associated with regional changes in perinatal outcomes such as stillbirth and preterm birth. Metropolitan Melbourne endured one of the longest and most stringent lockdowns in 2020. This paper presents the protocol for a collaborative maternity dashboard project to monitor perinatal outcomes in Melbourne, Australia, during the COVID-19 pandemic.

Methods

De-identified maternal and newborn outcomes will be collected monthly from all public maternity services in Melbourne, allowing rapid analysis of a multitude of perinatal indicators. Weekly outcomes will be displayed as run charts according to established methods for detecting non-random ‘signals’ in health care. A pre-pandemic median for all indicators will be calculated for the period of January 2018 to March 2020. A significant shift is defined as ≤ six consecutive weeks, all above or below the pre-pandemic median. Additional statistical analyses such as regression, time-series, and survival analyses will be performed for an in-depth examination of maternal and perinatal outcomes of interests.

Ethics and Dissemination

This study has been registered as an observational study with the Australian and New Zealand Clinical Trials Registry (ACTRN12620000878976).

Strengths and weaknesses of this study

  • ⍰ This project is the first clinician-led, multi-centre perinatal data collection system for metropolitan Melbourne.

  • ⍰ It complements the state government data collection, with the significant benefits of more timely and flexible reporting of outcomes, and granular detail on emerging areas of concern.

  • ⍰ The study relies on primary source coding of exposure and outcomes from each hospital that have not been internally validated during the study period.

  • ⍰ Data from private maternity hospitals, containing 25% of Melbourne births, are not available.

  • ⍰ This resource will support data-informed hospital pandemic responses through to the end of 2022.

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    1. ScreenIT

      SciScore for 10.1101/2021.07.22.21261008: (What is this?)

      Please note, not all rigor criteria are appropriate for all manuscripts.

      Table 1: Rigor

      EthicsField Sample Permit: Authorised representatives of the sponsoring institution as well as representatives from the human research ethics committees, research governance office and regulatory agencies may inspect all documents and records required to be maintained by the CPI in this study.
      IRB: Authorised representatives of the sponsoring institution as well as representatives from the human research ethics committees, research governance office and regulatory agencies may inspect all documents and records required to be maintained by the CPI in this study.
      Consent: Local site study documents will be stored for at least 15 years and will not be destroyed without the written consent of the CPI.
      Sex as a biological variableLevel 4 centres provide local care for low-risk mothers and babies including births from 34 weeks’ gestation.
      Randomizationnot detected.
      Blindingnot detected.
      Power Analysisnot detected.

      Table 2: Resources

      Software and Algorithms
      SentencesResources
      Study data will be collected and managed using REDCap electronic data capture tools [12] hosted at The University of Melbourne.
      REDCap
      suggested: (REDCap, RRID:SCR_003445)
      Deidentified individual patient-level data on ≤ 100 fields will be analysed in STATA SE v16 [13].
      STATA
      suggested: (Stata, RRID:SCR_012763)

      Results from OddPub: Thank you for sharing your data.

      Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
      However, there are limitations to the data collection methods, including missing data on planned home births, private hospital births, and COVID-19 infection rates in pregnancy. There are also hospital-specific variations to the many data collection fields, requiring manual recoding and collation before indicators can be generated. There are potential risks related to data security. However, as no personally-identifying information will be collected in this study, there is no possibility of breaches of privacy or confidentiality. The risks to the successful conduct of the study include inadequate health service resources to collect and submit the data or insufficient study resources to clean and analyse data on a continuous basis. We have designed this study to leverage existing routine data reporting tools to minimise the burden on health services. We have also obtained philanthropic and University funding to support the central data management and report generation (see Funding declarations).

      Results from TrialIdentifier: No clinical trial numbers were referenced.

      Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

      Results from JetFighter: We did not find any issues relating to colormaps.

      Results from rtransparent:
      • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
      • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
      • No protocol registration statement was detected.

      Results from scite Reference Check: We found no unreliable references.

      About SciScore

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    2. Version published to 10.1101/2021.07.22.21261008v3 on medRxiv
    3. Version published to 10.1101/2021.07.22.21261008v2 on medRxiv
    4. Version published to 10.1101/2021.07.22.21261008v1 on medRxiv