EUROlinkCAT Protocol for a European population-based data linkage study investigating the survival, morbidity and education of children with congenital anomalies

Joan K Morris, Ester Garne, Maria Loane, Ingeborg Barišić, James Densem, Anna Latos-Bieleńska, Amanda Neville, Anna Pierini, Judith Rankin, Anke Rissmann, Hermien E.K. de Walle, Joachim Tan, Joanne Given, Hugh Claridge

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IntroductionCongenital anomalies (CAs) are a major cause of infant mortality, childhood morbidity and long-term disability. Over 130 000 children born in Europe every year will have a CA. This paper describes the EUROlinkCAT study, which is investigating the health and educational outcomes of children with CAs for the first 10 years of their lives.Methods and analysisEUROCAT is a European network of population-based registries for the epidemiological surveillance of CAs. EUROlinkCAT is using the EUROCAT infrastructure to support 22 EUROCAT registries in 14 countries to link their data on births with CAs to mortality, hospital discharge, prescription and educational databases. Once linked, each registry transforms their case data into a common data model (CDM) format and they are then supplied with common STATA syntax scripts to analyse their data. The resulting aggregate tables and analysis results are submitted to a central results repository (CRR) and meta-analyses are performed to summarise the results across all registries. The CRR currently contains data on 155 594 children with a CA followed up to age 10 from a population of 6 million births from 1995 to 2014.EthicsThe CA registries have the required ethics permissions for routine surveillance and transmission of anonymised data to the EUROCAT central database. Each registry is responsible for applying for and obtaining additional ethics and other permissions required for their participation in EUROlinkCAT.DisseminationThe CDM and associated documentation, including linkage and standardisation procedures, will be available post-EUROlinkCAT thus facilitating future local, national and European-level analyses to improve healthcare. Recommendations to improve the accuracy of routinely collected data will be made.Findings will provide evidence to inform parents, health professionals, public health authorities and national treatment guidelines to optimise diagnosis, prevention and treatment for these children with a view to reducing health inequalities in Europe.
Original languageEnglish
Article numbere047859
Number of pages14
JournalBMJ Open
Issue number6
Early online date28 Jun 2021
Publication statusE-pub ahead of print - 28 Jun 2021


  • Protocol
  • Congenital Anomalies
  • Linkage
  • Mortality
  • Morbidity
  • paediatrics
  • epidemiology
  • statistics & research methods


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