当前位置： SCI文献检索 > CIRCULATION期刊下所有文献 > Study of Cardiovascular Health Outcomes in the Era of Claims Data: The Cardiovascular Health Study.

Study of Cardiovascular Health Outcomes in the Era of Claims Data: The Cardiovascular Health Study.

Abstract：

BACKGROUND:Increasingly, the diagnostic codes from administrative claims data are being used as clinical outcomes. METHODS AND RESULTS:Data from the Cardiovascular Health Study (CHS) were used to compare event rates and risk factor associations between adjudicated hospitalized cardiovascular events and claims-based methods of defining events. The outcomes of myocardial infarction (MI), stroke, and heart failure were defined in 3 ways: the CHS adjudicated event (CHS[adj]), selected International Classification of Diseases, Ninth Edition diagnostic codes only in the primary position for Medicare claims data from the Center for Medicare & Medicaid Services (CMS[1st]), and the same selected diagnostic codes in any position (CMS[any]). Conventional claims-based methods of defining events had high positive predictive values but low sensitivities. For instance, the positive predictive value of International Classification of Diseases, Ninth Edition code 410.x1 for a new acute MI in the first position was 90.6%, but this code identified only 53.8% of incident MIs. The observed event rates for CMS[1st] were low. For MI, the incidence was 14.9 events per 1000 person-years for CHS[adj] MI, 8.6 for CMS[1st] MI, and 12.2 for CMS[any] MI. In general, cardiovascular disease risk factor associations were similar across the 3 methods of defining events. Indeed, traditional cardiovascular disease risk factors were also associated with all first hospitalizations not resulting from an MI. CONCLUSIONS:The use of diagnostic codes from claims data as clinical events, especially when restricted to primary diagnoses, leads to an underestimation of event rates. Additionally, claims-based events data represent a composite end point that includes the outcome of interest and selected (misclassified) nonevent hospitalizations.

journal_name

Circulation

journal_title

Circulation

authors

Psaty BM,Delaney JA,Arnold AM,Curtis LH,Fitzpatrick AL,Heckbert SR,McKnight B,Ives D,Gottdiener JS,Kuller LH,Longstreth WT Jr

doi

10.1161/CIRCULATIONAHA.115.018610

subject

Has Abstract

pub_date

2016-01-12 00:00:00

pages

156-64

issue

eissn

0009-7322

issn

1524-4539

pii

CIRCULATIONAHA.115.018610

journal_volume

133

pub_type

杂志文章,多中心研究

在线工具

Study of Cardiovascular Health Outcomes in the Era of Claims Data: The Cardiovascular Health Study.