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Validity of myocardial infarction diagnoses in administrative databases: a systematic review.
Open accessAbstract
BACKGROUND: Though administrative databases are increasingly being used for research related to myocardial infarction (MI), the validity of MI diagnoses in these databases has never been synthesized on a large scale. OBJECTIVE: To conduct the first systematic review of studies reporting on the validity of diagnostic codes for identifying MI in administrative data. METHODS: MEDLINE and EMBASE were searched (inception to November 2010) for studies: (a) Using administrative data to identify MI; or (b) Evaluating the validity of MI codes in administrative data; and (c) Reporting validation statistics (sensitivity, specificity, positive predictive value (PPV), negative predictive value, or Kappa scores) for MI, or data sufficient for their calculation. Additonal articles were located by handsearch (up to February 2011) of original papers. Data were extracted by two independent reviewers; article quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. RESULTS: Thirty studies published from 1984-2010 were included; most assessed codes from the International Classification of Diseases (ICD)-9th revision. Sensitivity and specificity of hospitalization data for identifying MI in most [≥50%] studies was ≥86%, and PPV in most studies was ≥93%. The PPV was higher in the more-recent studies, and lower when criteria that do not incorporate cardiac troponin levels (such as the MONICA) were employed as the gold standard. MI as a cause-of-death on death certificates also demonstrated lower accuracy, with maximum PPV of 60% (for definite MI). CONCLUSIONS: Hospitalization data has higher validity and hence can be used to identify MI, but the accuracy of MI as a cause-of-death on death certificates is suboptimal, and more studies are needed on the validity of ICD-10 codes. When using administrative data for research purposes, authors should recognize these factors and avoid using vital statistics data if hospitalization data is not available to confirm deaths from MI.
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“Second, conditions were defined using ICD-10 diagnosis codes. Differences in coding practices might exist; however, coding for common conditions, especially the life-threatening conditions described in this report, is likely consistent (9,10).”
From Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions — United States, January–May 2020 (2020) · cites this paper as [9]
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Metadata
- Authors
- McCormick, N., Lacaille, D., Bhole, V., & Avina-Zubieta, J. A.
- Affiliations
- University of British Columbia (CA)
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-03-28
- Volume
- 9
- Issue
- 3
- Pages
- e92286
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3969323
- OpenAlex
- W2016940795
- Cited by
- 262
- References
- 73
- Citations by year
- 2026: 18 · 2025: 16 · 2024: 14 · 2023: 12 · 2022: 25 · 2021: 29 · 2020: 36 · 2019: 34 · 2018: 16 · 2017: 30 · 2016: 14 · 2015: 14 · 2014: 3
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Arthritis Society
- Canadian Arthritis Network
- Topics
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Keywords
- myocardial infarction, administrative databases, diagnostic validity, ICD-9 codes, ICD-10 codes, hospitalization data, death certificates, causes of death, cardiac troponin, positive predictive value, sensitivity and specificity
- MeSH terms
- Adult, Aged, Death Certificates, Hospitalization, Humans, Middle Aged, Myocardial Infarction, Sensitivity and Specificity, Databases, Factual, International Classification of Diseases, Young Adult, Clinical Coding
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