Proposed Data Collection Submitted for Public Comment and Recommendations

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Published

January 11, 2023

Issuing agencies

Health and Human Services DepartmentCenters for Disease Control and Prevention

Abstract

The Centers for Disease Control and Prevention (CDC), as part of its continuing effort to reduce public burden and maximize the utility of government information, invites the general public and other federal agencies the opportunity to comment on a continuing information collection, as required by the Paperwork Reduction Act of 1995. This notice invites comment on a proposed information collection project titled Maternal Mortality Review Information Application (MMRIA). MMRIA is a standardized data collection system that allows Maternal Mortality Review Committees (MMRCs) to abstract relevant data from a variety of sources, document committee decisions, and analyze data to better understand the contributing factors and preventability of pregnancy- related deaths in order to develop recommendations for prevention.

Full Text

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<title>Federal Register, Volume 88 Issue 7 (Wednesday, January 11, 2023)</title>
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[Federal Register Volume 88, Number 7 (Wednesday, January 11, 2023)]
[Notices]
[Pages 1580-1582]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-00334]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-23-1294; Docket No. CDC-2022-0143]

Proposed Data Collection Submitted for Public Comment and
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).

ACTION: Notice with comment period.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), as part
of its continuing effort to reduce public burden and maximize the
utility of government information, invites the general public and other
federal agencies the opportunity to comment on a continuing information
collection, as required by the Paperwork Reduction Act of 1995. This
notice invites comment on a proposed information collection project
titled Maternal Mortality Review Information Application (MMRIA). MMRIA
is a standardized data collection system that allows Maternal Mortality
Review Committees (MMRCs) to abstract relevant data from a variety of
sources, document committee decisions, and analyze data to better
understand the contributing factors and preventability of pregnancy-
related deaths in order to develop recommendations for prevention.

DATES: CDC must receive written comments on or before March 13, 2023.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2022-
0143 by either of the following methods:
<bullet> Federal eRulemaking Portal: <a href="http://www.regulations.gov">www.regulations.gov</a>. Follow
the instructions for submitting comments.
<bullet> Mail: Jeffrey M. Zirger, Information Collection Review
Office, Centers for Disease Control and Prevention, 1600 Clifton Road
NE, MS H21-8, Atlanta, Georgia 30329.
Instructions: All submissions received must include the agency name
and Docket Number. CDC will post, without change, all relevant comments
to <a href="http://www.regulations.gov">www.regulations.gov</a>.
Please note: Submit all comments through the Federal eRulemaking
portal (<a href="http://www.regulations.gov">www.regulations.gov</a>) or by U.S. mail to the address listed
above.

FOR FURTHER INFORMATION CONTACT: To request more information on the
proposed project or to obtain a copy of the information collection plan
and instruments, contact Jeffrey M. Zirger, Information Collection
Review Office, Centers for Disease Control and Prevention, 1600 Clifton
Road NE, MS H21-8, Atlanta, Georgia 30329; Telephone: 404-639-7118;
Email: <a href="/cdn-cgi/l/email-protection#741b1916341710175a131b02"><span class="__cf_email__" data-cfemail="d8b7b5ba98bbbcbbf6bfb7ae">[email&#160;protected]</span></a>.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from
the Office of Management and Budget (OMB) for each collection of
information they conduct or sponsor. In addition, the PRA also requires
federal agencies to provide a 60-day notice in the Federal Register
concerning each proposed collection of information, including each new
proposed collection, each proposed extension of existing collection of
information, and each reinstatement of previously approved information
collection before submitting the collection to the OMB for approval. To
comply with this requirement, we are publishing this notice of a
proposed data collection as described below.
The OMB is particularly interested in comments that will help:
1. Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
2. Evaluate the accuracy of the agency's estimate of the burden of
the proposed collection of information, including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and clarity of the information to
be collected;
4. Minimize the burden of the collection of information on those
who are to respond, including through the use of appropriate automated,
electronic, mechanical, or other technological collection techniques or
other forms of information technology, e.g., permitting electronic
submissions of responses; and
5. Assess information collection costs.

[[Page 1581]]

Proposed Project

The Maternal Mortality Review Information Application (MMRIA) (OMB
Control No. 0920-1294, Exp. 04/30/2023)--Revision--National Center for
Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for
Disease Control and Prevention (CDC).

Background and Brief Description

The Centers for Disease Control and Prevention (CDC) seeks a
Revision to continue to collect information through the Maternal
Mortality Review Information Application (MMRIA) for three more years.
MMRIA is a standardized data collection system that allows Maternal
Mortality Review Committees (MMRCs) across the country to abstract
relevant data (clinical and non-clinical) from a variety of sources,
document committee decisions, and analyze data in order to better
understand the contributing factors and preventability of pregnancy-
related deaths and thus to develop recommendations for prevention.
Pregnancy-related deaths are defined as a death as a result of
pregnancy or delivery complications, a chain of events initiated by
pregnancy, or the aggravation of an unrelated condition by the
physiologic effects of pregnancy. Considerable racial disparities
exist, with persons who are American Indian/Alaska Native and Black
persons two to three times more likely to die from pregnancy-related
complications than persons who are White. Findings from analyses of
aggregated MMRC data indicate that about four out of five pregnancy-
related deaths are preventable.
Maternal Mortality Review is a process by which a multidisciplinary
committee at the jurisdiction level identifies and reviews cases of
death that occur during or within one year of end of pregnancy. Members
of MMRCs typically represent public health, obstetrics and gynecology,
maternal-fetal medicine, nursing, midwifery, forensic pathology, mental
and behavioral health, community-based organizations, and other
relevant partners. Through a partnership among the MMRC, state vital
records office, and epidemiologists, deaths among females of
reproductive age are examined to determine if they occurred during
pregnancy or within one year of the end of pregnancy (i.e., pregnancy-
associated deaths). Through this process, potential cases of pregnancy-
related deaths (i.e., death from any cause related to or aggravated by
pregnancy or its management) are then identified. Review committees
access multiple sources of clinical and non-clinical information to
understand the circumstances surrounding a death in order to determine
pregnancy-relatedness and develop recommendations for action to prevent
similar deaths in the future.
MMRIA is a standardized data collection system designed to support
MMRC processes. Data are abstracted and entered into MMRIA from various
sources, including death records, autopsy reports, birth and fetal
death records, prenatal care records, emergency department visit
records, hospitalization records, records from other medical office
visits, medical transport records, social and environmental profiles,
mental health profiles, and informant interviews. Case narratives for
committee reviews are developed from the abstracted data entered into
MMRIA to facilitate committee review, and committee decisions based on
their review are also be entered into MMRIA. The data collected in
MMRIA is used to facilitate an understanding of the drivers of maternal
mortality and complications of pregnancy and associated disparities;
determine what interventions at patient, provider, facility, system,
and community levels will have the most impact; and implement data
driven recommendations.
The burden estimates presented here are applicable to the 40
jurisdictions with funding support through the cooperative agreements
Preventing Maternal Deaths: Supporting Maternal Mortality Review
Committees (CDC-RFA-DP19-1908) and Preventing Maternal Mortality:
Supporting Maternal Mortality Review Committees CDC-RFA-DP22-2211)
which includes 39 direct awardees and one sub-awardee. These
jurisdictions are required to compile a defined set of information
about pregnancy-related deaths into MMRIA. It is estimated that
information will be collected for a total of 1,983 pregnancy-associated
deaths on average, annually, among the 40 jurisdictions with funding
support through CDC-RFA-DP19-1908 and CDC-RFA-DP22-2211. For 23
jurisdictions, it is estimated that on average, 15 hours of data
abstraction are required for each death entered into MMRIA. The other
17 jurisdictions are able to participate in a process to reduce burden
by which CDC uploads vital records information into MMRIA rather than
jurisdiction staff manually abstracting vital records. For these 17
jurisdictions, the estimated average is 14 hours of abstraction for
each death entered into MMRIA. For all jurisdictions with funding
support through CDC-RFA-DP19-1908 and CDC-RFA-DP22-2211, an additional
24 minutes on average is needed to enter the committee decisions into
MMRIA.
There are four changes that result in this request for revision,
with the first three having an impact on the estimated burden for this
revision. First, through additional congressional appropriations, an
additional 15 jurisdictions are now funding recipients. This represents
an increase from 24 to 39 funding recipients. There is a total of 40
respondents, because one funding recipient provides a subaward to an
additional respondent. Second, CDC estimates a higher number of
pregnancy-associated deaths due to utilizing data from the Pregnancy
Mortality Surveillance System (PMSS) rather than CDC WONDER for these
estimates. PMSS estimates of pregnancy-associated deaths are more
accurate due to more comprehensive and complete identification of these
deaths through multiple case identification methods. Third, CDC has
been working with the National Association for Public Health Statistics
and Information Systems on an initiative that enables CDC to transfer
vital records data associated with CDC identified pregnancy-associated
deaths directly into a jurisdiction's instance of MMRIA, reducing
manual data entry burden for the 17 respondents participating in the
initiative. Fourth, to address user identified needs and increase data
use for analysis by jurisdictions, a total of 60 new optional fields
were added to MMRIA, three fields removed, and two fields combined.
None of the added fields are required fields.
These changes resulted in an overall increase to the estimated
burden from the previous approval. CDC requests OMB approval for an
estimated 29,950 annual burden hours. There is no cost to respondents
other than their time to participate.

[[Page 1582]]

Estimated Annualized Burden Hours
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Average
Number of Number of burden per Total
Type of respondent Form name respondents responses per response burden
respondent (in hr) (in hr)
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Jurisdictions with funding support MMRIA data 23 50 15 17,250
through CDC-RFA-DP19-1908 and CDC- abstraction.
RFA-DP22-2211 who manually abstract
all data into MMRIA.
Jurisdictions with funding support MMRIA data 17 50 14 11,900
through CDC-RFA-DP19-1908 and CDC- abstraction.
RFA-DP22-2211 for which CDC is
uploading vital records into MMRIA
and jurisdiction staff abstract
remaining data manually into MMRIA.
All jurisdictions with funding MMRIA committee 40 50 0.4 800
support through CDC-RFA-DP19-1908 decisions form.
and CDC-RFA-DP22-2211.
----------------------------------------------------
Total........................... ..................... ........... .............. ........... 29,950
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific
Integrity, Office of Science, Centers for Disease Control and
Prevention.
[FR Doc. 2023-00334 Filed 1-10-23; 8:45 am]
BILLING CODE 4163-18-P

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