Positive Predictive Value of the Diagnosis of Acute Myocardial Infarction in an Administrative Database

Authors

  • Laura A. Petersen MD, MPH,

    1. Center for the Study of Practice Patterns in Acute Myocardial Infarction, Health Services Research and Development, Brockton/West Roxbury VA Medical Center, and Department of Medicine, Harvard Medical School, Boston, Mass
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  • Steven Wright PhD,

    1. Center for the Study of Practice Patterns in Acute Myocardial Infarction, Health Services Research and Development, Brockton/West Roxbury VA Medical Center, and Department of Medicine, Harvard Medical School, Boston, Mass
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  • Sharon-Lise T. Normand PhD,

    1. Department of Health Care Policy, Harvard Medical School, and Department of Biostatistics, Harvard School of Public Health, Boston, Mass
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  • Jennifer Daley MD

    1. Center for the Study of Practice Patterns in Acute Myocardial Infarction, Health Services Research and Development, Brockton/West Roxbury VA Medical Center, and Department of Medicine, Harvard Medical School, Boston, Mass
    2. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Mass
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Address correspondence and reprint requests to Dr. Petersen: Health Services Research and Development (152), Houston Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX 77030.

Abstract

OBJECTIVE: To determine the positive predictive value of ICD-9-CM coding of acute myocardial infarction and cardiac procedures.

METHODS:Using chart-abstracted data as the standard, we examined administrative data from the Veterans Health Administration for a national random sample of 5,151 discharges.

MAIN RESULTS: The positive predictive value of acute myocardial infarction coding in the primary position was 96.9%. The sensitivity and specificity of coding were, respectively, 96% and 99% for catheterization, 95.7% and 100% for coronary artery bypass graft surgery, and 90.3% and 99.7% for percutaneous transluminal coronary angioplasty.

CONCLUSIONS: The positive predictive value of acute myocardial infarction and related procedure coding is comparable to or better than previously reported observations of administrative databases.

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