Usefulness of the National Congenital Anomaly Service (NCAS)
| Criterion | The extent to which these are met by the NCAS |
|---|---|
| Detection of trends | The NCAS can be used to detect trends in notification, which is performed annually. Trends in congenital anomaly occurrence cannot be monitored because of the considerable under-reporting within the passive system |
| Providing estimates of morbidity and mortality | Owing to under-reporting of anomalies to the NCAS, it does not provide reliable estimates of the magnitude of morbidity and mortality related to congenital anomalies. Moreover, the NCAS is currently on a stand alone database, which does not routinely link to births and deaths records to produce analysis of survival and death rates. These have to be derived from linkage studies, registers, or extrapolation |
| Epidemiological research likely to lead to control or prevention | The registers have very good quality data which are used for epidemiological research. The national data are less often used for research because of their variable quality |
| Identification of risk factors | The NCAS is unable to identify risk factors at national level, as several key fields have a large percentage of unknown and blank responses (table 2), but the registers are able to produce this analysis |
| Improvement of clinical practice | The registers’ databases have been used for various audits that have led to improved clinical practice, but the national data have not been used for this purpose |
| Influencing public health policy | Studies using the national data and data from the registers have influenced the development of the policy on folic acid supplementation in the peri-conceptional period |