Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review.
Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review.
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DOI：
10.1186/s12874-021-01440-5
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发表时间：
2021-11-06
影响因子：
4
通讯作者：
Saade E
中科院分区：
文献类型：
--
作者：
Bosco E;Hsueh L;McConeghy KW;Gravenstein S;Saade E
在随机对照试验（RCT）和观察性研究中，主要心血管不良事件（MACE）越来越多地用作复合结局。然而，目前尚不清楚在使用管理数据时，观察性研究如何在文献中最常见地定义MACE。我们识别了2010年1月1日至2020年10月9日期间在MEDLINE和EMBASE上发表的同行评审文章。纳入了使用国际疾病分类第9版或第10版诊断代码，利用管理数据评估MACE复合结局的研究。排除了未提供结局代码定义的综述、摘要和研究。提取的数据包括数据源、时间范围、MACE组件、代码定义、代码位置和结局验证。共筛选了920篇文章，保留412篇进行全文审查，纳入58篇。只有8.6%（n = 5/58）符合急性心肌梗死（AMI）、卒中或心血管死亡的传统三点MACE RCT定义。没有匹配的四点（+不稳定型心绞痛）或五点MACE（+不稳定型心绞痛和心力衰竭）。最常见的MACE组分为：AMI和卒中，15.5%（n = 9/58）; AMI、卒中和全因死亡，13.8%（n = 8/58）; AMI、卒中和心血管死亡8.6%（n = 5/58）。此外，67%（n = 39/58）未验证结局或引用验证研究。此外，70.7%（n = 41/58）未报告终点的代码位置，20.7%（n = 12/58）使用主要位置，8.6%（n = 5/58）使用任何位置。在观察性研究中，MACE终点的组成和使用的诊断代码差异很大。观察性研究中使用的MACE定义和报告的信息存在差异，因此无法对结果进行比较、复制和汇总。研究应透明地报告所使用的行政代码和代码位置，并在可能时使用经验证的结果定义。在线版本包含补充材料，可通过10.1186/s12874-021-01440-5获得。
Major adverse cardiovascular events (MACE) are increasingly used as composite outcomes in randomized controlled trials (RCTs) and observational studies. However, it is unclear how observational studies most commonly define MACE in the literature when using administrative data. We identified peer-reviewed articles published in MEDLINE and EMBASE between January 1, 2010 to October 9, 2020. Studies utilizing administrative data to assess the MACE composite outcome using International Classification of Diseases 9th or 10th Revision diagnosis codes were included. Reviews, abstracts, and studies not providing outcome code definitions were excluded. Data extracted included data source, timeframe, MACE components, code definitions, code positions, and outcome validation. A total of 920 articles were screened, 412 were retained for full-text review, and 58 were included. Only 8.6% (n = 5/58) matched the traditional three-point MACE RCT definition of acute myocardial infarction (AMI), stroke, or cardiovascular death. None matched four-point (+unstable angina) or five-point MACE (+unstable angina and heart failure). The most common MACE components were: AMI and stroke, 15.5% (n = 9/58); AMI, stroke, and all-cause death, 13.8% (n = 8/58); and AMI, stroke and cardiovascular death 8.6% (n = 5/58). Further, 67% (n = 39/58) did not validate outcomes or cite validation studies. Additionally, 70.7% (n = 41/58) did not report code positions of endpoints, 20.7% (n = 12/58) used the primary position, and 8.6% (n = 5/58) used any position. Components of MACE endpoints and diagnostic codes used varied widely across observational studies. Variability in the MACE definitions used and information reported across observational studies prohibit the comparison, replication, and aggregation of findings. Studies should transparently report the administrative codes used and code positions, as well as utilize validated outcome definitions when possible. The online version contains supplementary material available at 10.1186/s12874-021-01440-5.
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影响因子：
5.3
作者：
Chang, Chia-Hsuin;Lee, Yen-Chieh;Lai, Mei-Shu
通讯作者：
Lai, Mei-Shu
影响因子：
5.4
作者：
Chang TE;Lichtman JH;Goldstein LB;George MG
通讯作者：
George MG
影响因子：
2.6
作者：
Cutrona, Sarah L.;Toh, Sengwee;Iyer, Aarthi;Foy, Sarah;Daniel, Gregory W.;Nair, Vinit P.;Ng, Daniel;Butler, Melissa G.;Boudreau, Denise;Forrow, Susan;Goldberg, Robert;Gore, Joel;McManus, David;Racoosin, Judith A.;Gurwitz, Jerry H.
通讯作者：
Gurwitz, Jerry H.
影响因子：
2.6
作者：
Andrade, Susan E.;Harrold, Leslie R.;Tjia, Jennifer;Cutrona, Sarah L.;Saczynski, Jane S.;Dodd, Katherine S.;Goldberg, Robert J.;Gurwitz, Jerry H.
通讯作者：
Gurwitz, Jerry H.
影响因子：
2.1
作者：
Chapman, Richard H.;Yeaw, Jason;Roberts, Craig S.
通讯作者：
Roberts, Craig S.