Paper 3: EUROCAT data quality indicators for population-based registries of congenital anomalies

The European Surveillance of Congenital Anomalies (EUROCAT) network of population-based congenital anomaly registries is an important source of epidemiologic information on congenital anomalies in Europe covering live births, fetal deaths from 20 weeks gestation, and terminations of pregnancy for fetal anomaly. EUROCAT's policy is to strive for high-quality data, while ensuring consistency and transparency across all member registries. A set of 30 data quality indicators (DQIs) was developed to assess five key elements of data quality: completeness of case ascertainment, accuracy of diagnosis, completeness of information on EUROCAT variables, timeliness of data transmission, and availability of population denominator information. This article describes each of the individual DQIs and presents the output for each registry as well as the EUROCAT (unweighted) average, for 29 full member registries for 2004-2008. This information is also available on the EUROCAT website for previous years. The EUROCAT DQIs allow registries to evaluate their performance in relation to other registries and allows appropriate interpretations to be made of the data collected. The DQIs provide direction for improving data collection and ascertainment, and they allow annual assessment for monitoring continuous improvement. The DQI are constantly reviewed and refined to best document registry procedures and processes regarding data collection, to ensure appropriateness of DQI, and to ensure transparency so that the data collected can make a substantial and useful contribution to epidemiologic research on congenital anomalies.     

Paper 1: The EUROCAT network--organization and processes

The European Surveillance of Congenital Anomalies (EUROCAT) is a network of population-based congenital anomaly registries in Europe, funded by the European Union, which has been in operation for more than 30 years. It currently surveys more than 1.7 million births per year, including 31% of births in the European Union, and includes almost all population-based European congenital anomaly registries as its members. EUROCAT member registries collect data, ascertained from multiple sources, on all major structural congenital and chromosomal anomalies. EUROCAT surveillance relates to three areas: prevalence, primary prevention, and prenatal screening. This article describes the history of EUROCAT and gives an overview of the current methodology and work of EUROCAT covering the database content and management, coding and classification of anomalies, core surveillance, prevalence tables, statistical monitoring. The monitoring of new developments in prenatal diagnosis, medication during pregnancy, use of folic acid, and investigation of clusters and exposures are overseen by working groups responsible for organizing research and producing regular reports. The EUROCAT Web site includes current data on prevalence rates and prenatal detection rates-an example of information useful to clinicians, public health service managers, and patients.     

Bacteriophages as indicators of enteric viruses and public health risk in groundwaters

1. Introduction, 5
2. Direct virus detection, 6
3. Bacteriophages, 6
3.1 Somatic coliphages, 8
3.2 F⁺-specific bacteriophages, 9
3.3 Bacteriophages infecting Bacteroides fragilis ,14
4. Summary, 15
5. Critical issues that must be addressed, 15
6. Acknowledgements, 15
7. References, 16     

Developing and testing alien species indicators for Europe

Alien species indicators provide vital information to the biodiversity policy sector on the status-quo and trends of biological invasions and on the efficacy of response measures. Applicable at different geographical scales and organizational levels, alien species indicators struggle with data availability and quality. Based on policy needs and previous work on the global scale, we here present a set of six alien species indicators for Europe, which capture complementary facets of biological invasions in Europe: (a) an combined index of invasion trends, (b) an indicator on pathways of invasions, (c) the Red List Index of Invasive Alien Species (IAS), (d) an indicator of IAS impacts on ecosystem services, (e) trends in incidence of livestock diseases and (f) an indicator on costs for alien species management and research. Each of these indicators has its particular strengths and shortcomings, but combined they allow for a nuanced understanding of the status and trends of biological invasions in Europe. We found that the scale and impact of biological invasions are steadily increasing across all impact indicators, although societal response in recent years has increased. The Red List Index is fit-for-purpose and demonstrates that overall extinction risks (here shown for amphibians in Europe) are increasing. Introduction pathway dynamics have changed, with some pathways decreasing in relevance (e.g., biological control agents) and others increasing (e.g., horticultural trade) providing a leverage for targeted policy and stakeholder response. The IAS indicators presented here for the first time on a continental basis serve as a starting point for future improvements, and as a basis for monitoring the efficacy of the recent EU legislation of IAS. This will need a better workflow for data collection and management. To achieve this, all main actors must work toward improving the interoperability among existing databases and between data holders.