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
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
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DOI：
10.1093/aje/kwh341
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发表时间：
2004-12-15
影响因子：
5
通讯作者：
Folsom, AR
中科院分区：
文献类型：
--
作者：
Rosamond, WD;Chambless, LE;Folsom, AR
出院诊断有效性的差异可能使急性心肌梗死（AMI）发病率趋势的评估复杂化。为了明确出院代码有效性的趋势，作者比较了基于已发表的社区动脉粥样硬化风险（ARIC）研究标准的事件分类与是否存在国际疾病分类第九版临床修改（ICD-9-CM） AMI出院代码（代码410）。1987年至2000年间，在四个ARIC社区中，154,836例涉及住院的冠心病事件使用ICD-9-CM代码筛查AMI。ICD-9-CM代码410对男性AMI分类的敏感性（敏感性= 0.65,95%可信区间（CI）： 0.63, 0.66）在统计学上显著高于女性（敏感性= 0.60,95% CI: 0.58, 0.62），白人（敏感性= 0.67,95% CI: 0.65, 0.68）高于黑人（敏感性= 0.50,95% CI: 0.47, 0.53）。与白人相比，黑人患高血压心脏病和充血性心力衰竭的频率更高，这与种族差异有关。作者发现，尽管ICD-9-CM代码410识别AMI的有效性从1987年到2000年总体上是稳定的，但黑人和白人之间以及不同地理位置之间的差异支持在正在进行的监测研究中进行验证工作的投资。
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.