A computer case definition for sudden cardiac death

Authors

  • Cecilia P. Chung M.D., MPH,

    1. Division of Rheumatology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
    Current affiliation:
    1. Department of Medicine, Johns Hopkins Bayview Hospital, Baltimore, MD, USA
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  • Katherine T. Murray M.D.,

    1. Division of Cardiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
    2. Division of Clinical Pharmacology, Departments of Medicine and Pharmacology, Vanderbilt University School of Medicine, Nashville, Nashville, TN, USA
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  • C. Michael Stein MB, ChB,

    1. Division of Rheumatology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
    2. Division of Clinical Pharmacology, Departments of Medicine and Pharmacology, Vanderbilt University School of Medicine, Nashville, Nashville, TN, USA
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  • Kathi Hall B.S.,

    1. Division of Pharmacoepidemiology, Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
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  • Wayne A. Ray Ph.D.

    Corresponding author
    1. Division of Pharmacoepidemiology, Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
    2. Geriatric Research, Education and Clinical Center, Nashville Veterans Administration Medical Center, Nashville, TN, USA
    • Department of Preventive Medicine, Village at Vanderbilt, Suite 2600, 1501 21st Ave South, Nashville, TN 37212, USA.
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  • No conflict of interest has been declared.

Abstract

Purpose

To facilitate studies of medications and sudden cardiac death, we developed and validated a computer case definition for these deaths. The study of community dwelling Tennessee Medicaid enrollees 30–74 years of age utilized a linked database with Medicaid inpatient/outpatient files, state death certificate files, and a state ‘all-payers’ hospital discharge file.

Methods

The computerized case definition was developed from a retrospective cohort study of sudden cardiac deaths occurring between 1990 and 1993. Medical records for 926 potential cases had been adjudicated for this study to determine if they met the clinical definition for sudden cardiac death occurring in the community and were likely to be due to ventricular tachyarrhythmias. The computerized case definition included deaths with (1) no evidence of a terminal hospital admission/nursing home stay in any of the data sources; (2) an underlying cause of death code consistent with sudden cardiac death; and (3) no terminal procedures inconsistent with unresuscitated cardiac arrest. This definition was validated in an independent sample of 174 adjudicated deaths occurring between 1994 and 2005.

Results

The positive predictive value of the computer case definition was 86.0% in the development sample and 86.8% in the validation sample. The positive predictive value did not vary materially for deaths coded according to the ICO-9 (1994–1998, positive predictive value = 85.1%) or ICD-10 (1999–2005, 87.4%) systems.

Conclusion

A computerized Medicaid database, linked with death certificate files and a state hospital discharge database, can be used for a computer case definition of sudden cardiac death. Copyright © 2009 John Wiley & Sons, Ltd.

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