What does this research mean for the field?

Routine hospital International Classification of Diseases (ICD) discharge data are insufficiently accurate compared to World Health Organization criteria to be used alone for monitoring trends in coronary heart disease morbidity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the diagnostic accuracy of routine hospital discharge coding for coronary heart disease against World Health Organization criteria.

February 1, 1987Australian and New Zealand Journal of Medicine

Validation of Coronary Heart Disease Hospital Discharge Data

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Why the study?

Does routine hospital discharge data accurately reflect true myocardial infarction cases according to WHO criteria in patients under 65?

Population

905 patients under 65 years of age admitted to hospital with coronary heart disease in Auckland in 1983

Comparison

Routine hospital discharge data (ICD coding) vs World Health Organization criteria

Design

Cross-sectional

Authors

RBR BeagleholeGeneral / Preventive / Lipids ASAlistair W. StewartNHS Lothian PWPETER M A CALVERLEY ABSTRACT PAUL P WALKERStatistics New Zealand

Discussion

Member takes

Implication

May overestimate true MI incidence in discharge data; leaves open validity of unvalidated ICD codes for CHD surveillance research.

Key Points

To assess the diagnostic accuracy of routine hospital discharge coding for coronary heart disease against World Health Organization criteria.
Linked 858 of 905 hospitalized patients aged under 65 years from a 1983 coronary heart disease register with routine hospital discharge records.
Evaluated International Classification of Diseases (ICD) discharge codes against standardized World Health Organization diagnostic categories.
Among patients with validated definite myocardial infarction, 86% received ICD code 410, 9% received codes 411–414, and 5% received other diagnostic codes.
Only 67% (405 of 604) of cases assigned ICD code 410 in hospital discharge data were confirmed as definite myocardial infarctions by World Health Organization criteria.

Structured PICO

Does routine hospital discharge data accurately reflect true myocardial infarction cases according to WHO criteria in patients under 65?

Population

905 patients under 65 years of age admitted to hospital with coronary heart disease in Auckland in 1983

Intervention

Routine hospital discharge data (ICD coding)

Comparator

World Health Organization criteria (coronary heart disease register)

Outcome

Diagnostic accuracy of ICD code 410 (acute myocardial infarction) compared to WHO criteria

Routine hospital ICD discharge codes for acute myocardial infarction have limited positive predictive value (67%) compared to standardized WHO criteria, suggesting they should not be used alone to monitor coronary heart disease morbidity trends.

Cite This Study

Beaglehole et al. (1987) studied this question.

synapsesocial.com/papers/6a1d76617328fa9a742f8aa5 https://doi.org/10.1111/j.1445-5994.1987.tb05048.x

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Validation of Coronary Heart Disease Hospital Discharge Data

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Validation of Coronary Heart Disease Hospital Discharge Data

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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