Appendix A: Technical Notes
Validation of 2011 ART Data
Site visits to assisted reproductive technology (ART) clinics for validation of 2011 ART data were conducted during April through June 2013. For validation of 2011 data, 35 of the 451 reporting clinics were randomly selected after taking into consideration the number of ART procedures performed at each clinic, some cycle and clinic characteristics, and whether the clinic had been selected before. During each validation visit, ART data reported by the clinic to the Centers for Disease Control and Prevention were compared with information documented in medical records.
For each clinic, the fully validated sample included up to 40 ART cycles resulting in pregnancy and up to 20 ART cycles not resulting in pregnancy. In total, 2,059 ART cycles performed in 2011 across the 35 clinics were randomly selected for full validation, along with 191 embryo banking cycles. The full validation included review of 1,324 cycles for which a pregnancy was reported, of which 393 were multiple-fetus pregnancies. In addition, among patients whose cycles were validated, we verified the number of ART cycles performed during 2011. For each of these patients, we compared the total number of ART cycles reported with the total number of ART cycles included in the medical record. If unreported cycles were identified in selected medical records, up to 10 of these cycles were also selected for partial validation.