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Trends in the sensitivity, positive predictive value, false-positive rate, and comparability ratio of hospital discharge diagnosis codes for acute myocardial infarction in four US communities, 1987-2000.

TitleTrends in the sensitivity, positive predictive value, false-positive rate, and comparability ratio of hospital discharge diagnosis codes for acute myocardial infarction in four US communities, 1987-2000.
Publication TypeJournal Article
Year of Publication2004
AuthorsRosamond WD, Chambless LE, Sorlie PD, Bell EM, Weitzman S, Smith CJ, Folsom AR
JournalAm J Epidemiol
Volume160
Issue12
Pagination1137-46
Date Published2004 Dec 15
ISSN0002-9262
KeywordsAdult, Aged, False Positive Reactions, Female, Humans, International Classification of Diseases, Male, Maryland, Middle Aged, Minnesota, Mississippi, Myocardial Infarction, North Carolina, Patient Discharge, Predictive Value of Tests, Reproducibility of Results
Abstract

Variations in the validity of hospital discharge diagnoses can complicate the assessment of trends in incidence of acute myocardial infarction (AMI). To clarify trends in the validity of discharge codes, the authors compared event classification based on published Atherosclerosis Risk in Communities (ARIC) Study criteria with the presence or absence of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) hospital discharge code for AMI (code 410). Between 1987 and 2000, 154,836 coronary heart disease events involving hospitalization in the four ARIC communities had ICD-9-CM codes screened for AMI. The sensitivity of ICD-9-CM code 410 for classifying AMI in men (sensitivity = 0.65, 95% confidence interval (CI): 0.63, 0.66) was statistically significantly greater than that found for women (sensitivity = 0.60, 95% CI: 0.58, 0.62) and was greater in Whites (sensitivity = 0.67, 95% CI: 0.65, 0.68) than in Blacks (sensitivity = 0.50, 95% CI: 0.47, 0.53). The ethnic difference was related to a greater frequency of hypertensive heart disease and congestive heart failure codes encompassing AMI among Blacks as compared with Whites. The authors found that although the validity of ICD-9-CM code 410 to identify AMI was generally stable from 1987 through 2000, differences between Blacks and Whites and across geographic locations support investment in validation efforts in ongoing surveillance studies.

DOI10.1093/aje/kwh341
Alternate JournalAm J Epidemiol
PubMed ID15583364
Grant ListN01 HC 55015 / HC / NHLBI NIH HHS / United States
N01 HC 55016 / HC / NHLBI NIH HHS / United States
N01 HC 55018 / HC / NHLBI NIH HHS / United States
N01 HC 55019 / HC / NHLBI NIH HHS / United States
N01 HC 55020 / HC / NHLBI NIH HHS / United States
N01 HC 55021 / HC / NHLBI NIH HHS / United States
N01 HC 55022 / HC / NHLBI NIH HHS / United States