Accuracy of claim data in the identification and classification of adults with congenital heart diseases in electronic medical records

Cohen, Sarah; Jannot, Anne‐Sophie; Iserin, Laurence; Bonnet, Damien; Burgun, Anita; Escudié, Jean-Baptiste

doi:10.1016/j.acvd.2018.07.002

Cited by 21 publications

(10 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Presence of CVD was defined as two or more separate International Classification of Disease (ICD), Ninth (ICD-9) or Tenth (ICD-10) edition diagnosis or Current Procedural Terminology (CPT) codes indicating either ischemic or nonischemic CVD, in either the inpatient or outpatient setting (Supplemental Table 1). Codes were selected from previously validated and utilized algorithms demonstrating a >95% specificity of single code use for coronary artery disease, peripheral arterial disease, cerebrovascular disease, heart failure, valvular disease, congenital heart disease, (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28), and >85% specificity of single code use for atrial fibrillation (29). Our study then requires two or more separate diagnostic codes to further increase specificity of our enrollment groups.…”

Section: Methodsmentioning

confidence: 99%

“…First, our study design was observational in nature meaning causality cannot be demonstrated. Second, there is potential misclassification of diagnoses within the ICD coding system, though codes were chosen based on rigorous review of validated claims-based algorithms (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). We additionally required two separate diagnosis codes at two separate healthcare encounters to increase our confidence in how we defined exposure groups and cancer incidence.…”

Section: Our Findings Build Upon Prior Studies a Study Of 32095 Indiv...mentioning

confidence: 99%

See 1 more Smart Citation

Risk of Cancer After Diagnosis of Cardiovascular Disease

Bell

Lei

Baylis

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Cardiovascular disease (CVD) and cancer share several risk factors. While preclinical models show that various types of CVD can accelerate cancer progression, clinical studies have not determined the impact of atherosclerosis on cancer risk. Objectives: To determine whether CVD, especially atherosclerotic CVD, is independently associated with incident cancer. Methods: Using IBM MarketScan claims data from over 130 million individuals, we identified 27 million cancer-free subjects with a minimum of 36 months of follow-up data. Individuals were stratified by presence or absence of CVD, with 1:1 propensity matching to control for cardiovascular risk factors, and cumulative risk of cancer was calculated. Additional analyses were performed according to CVD type (atherosclerotic vs non-atherosclerotic) and cancer subtype. Results: Among 4,487,412 matched individuals, those with CVD had a 1.26-fold higher relative risk of cancer than those without CVD (6.8% vs 5.4% 5-year cumulative incidence). Results were more pronounced for individuals with atherosclerotic CVD (aCVD), who had a 1.43-fold higher relative risk than those without CVD (7.7% 5-year cumulative cancer incidence). Findings persisted after multivariable adjustment for numerous traditional CV risk factors, including the modestly higher risk for cancer amongst individuals with atherosclerotic CVD. Cancer subtype analyses showed specific associations of aCVD with several malignancies, including lung, bladder, liver, brain, and other hematologic cancers. Conclusions: Individuals with CVD have an increased risk of developing cancer compared to those without CVD. This association may be driven in part by the relationship of atherosclerosis with specific cancer subtypes, which persists after controlling for conventional risk factors.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Our Findings Build Upon Prior Studies a Study Of 32095 Indiv...mentioning

confidence: 99%

Risk of Cancer After Diagnosis of Cardiovascular Disease

Bell

Lei

Baylis

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In addition, patients with valvular heart disease of probable degenerative origin often received a diagnosis of CHD. While administrative databases vary in accuracy of CHD diagnoses [43][44][45][46] it seems that in our system, the NPR is dependable for diagnosis of MI in patients with CHD.…”

Section: Discussionmentioning

confidence: 93%

Validation of myocardial infarction diagnosis in patients with congenital heart disease in Sweden

Fedchenko

Mandalenakis

Hultsberg-Olsson

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background The population of adults with congenital heart disease (CHD) is growing, and increasingly more patients with CHD reach older ages. Patients with CHD are at an increased risk of myocardial infarction (MI) with increased age. Diagnosing MI in patients with CHD can be challenging in clinical practice owing to a high prevalence of aberrant electrocardiograms, ventricular hypertrophy, and heart failure, among other factors. The National Swedish Patient Register (NPR) is widely used in epidemiological studies; however, MI diagnoses specifically in patients with CHD have never been validated in the NPR. Methods We contacted hospitals and medical archive services to request medical records for 249 patients, born during 1970–2012, with both CHD and MI diagnoses and who were randomly selected from the NPR by the Swedish National Board of Health and Welfare. Follow-up was until 2015. We performed a medical chart review to validate the MI diagnoses; we also validated CHD diagnoses to ensure that only patients with confirmed CHD diagnoses were included in the MI validation process. Results We received medical records for 96.4% (n = 238/249) of patients for validation of CHD diagnoses. In total, 74.8% (n = 178/238) had a confirmed CHD diagnosis; of these, 70.2% (n = 167) had a fully correct CHD diagnosis in the NPR; a further 4.6% (n = 11) had a CHD diagnosis, but it was misclassified. MI diagnoses were validated in 167 (93.8%) patients with confirmed CHD. Of the patients with confirmed CHD, 88.0% (n = 147/167) had correct MI diagnoses. Patients with non-complex CHD diagnoses had more correct MI diagnoses than patients with complex CHD (91.0%, n = 131 compared with 69.6%, n = 16). The main cause for incorrect MI diagnoses was typographical error, contributing to 50.0% of the incorrect diagnoses. Conclusions The validity of MI diagnoses in patients with confirmed CHD in the NPR is high, with nearly 9 of 10 MI diagnoses being correct (88.0%). MI in patients with CHD can safely be studied using the NPR.

show abstract

“…ICD‐10 codes help classify diagnosis, but may be nonspecific, especially for adults with complex anatomy. Multiple studies have described the accuracy of ICD‐10 codes to identify ACHD patients compared to the gold standard of medical record review with variable results (Cohen et al, 2019; Khan et al, 2018; Steiner et al, 2018). Steiner et al reported reasonable accuracy of ACHD patient identification using ICD‐9 and ICD‐10 codes, but correct identification of certain lesions varied.…”

Section: Discussionmentioning

confidence: 99%

Lesion‐specific mortality due to congenital heart disease in U.S. adults from 1999 to 2017

Lynn

Salemi

Meath

et al. 2022

Birth Defects Research

View full text Add to dashboard Cite

Background: Adults with congenital heart disease (ACHD) comprise an increasing proportion of individuals living with CHD in the United States (US) although little is known regarding lesion or age-specific mortality in the modern era. Our study aimed to describe current era ACHD mortality rates by age and CHD lesion and provide temporal mortality rate trends for the last two decades. Methods: We conducted a 19-year analysis (1999-2017) of publicly available, de-identified Multiple Cause of Death data compiled and produced by the National Center for Health Statistics. Age and lesion-specific mortality rates were calculated using joinpoint regression.Results: ACHD mortality rates decreased by an average of 2%-4% per year for all adults. CHD lesions resulting in the highest ACHD-related mortality varied by age. Unlike the other lesions, mortality attributed to single ventricle physiology failed to improve in early adulthood (average of 1.6% increase per year).In decedents age 65 years or older, simpler forms of CHD like shunt lesions became more prominent contributors, accounting for 46% of deaths. Conclusion:Rates of mortality due to ACHD have declined significantly for adults with CHD, however, continued mortality due to single ventricle physiology remains an area requiring improved strategies to increase survival.

show abstract

Accuracy of claim data in the identification and classification of adults with congenital heart diseases in electronic medical records

Cited by 21 publications

References 40 publications

Risk of Cancer After Diagnosis of Cardiovascular Disease

Risk of Cancer After Diagnosis of Cardiovascular Disease

Validation of myocardial infarction diagnosis in patients with congenital heart disease in Sweden

Lesion‐specific mortality due to congenital heart disease in U.S. adults from 1999 to 2017

Contact Info

Product

Resources

About