Related Experiment Video
Updated: Mar 11, 2026
Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
Published on: September 26, 2018
Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study
Jens Sundbøll1,2, Kasper Adelborg1,2, Troels Munch1
1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
Insights
The Danish National Patient Registry
Area of Science:
- Cardiology
- Epidemiology
- Health Informatics
Background:
- Cardiovascular diagnoses in the Danish National Patient Registry (DNPR) are widely used in research.
- Validation of these diagnoses is crucial for ensuring research accuracy.
Purpose of the Study:
- To examine the positive predictive value (PPV) of cardiovascular diagnoses recorded in the DNPR.
- To assess the reliability of DNPR data for epidemiological studies.
Main Methods:
- A population-based validation study was conducted.
- Up to 100 patients per diagnosis were randomly sampled from hospitals in the Central Denmark Region (2010-2012).
- Medical record review served as the reference standard to determine PPVs for ICD-10 coded diagnoses.
Main Results:
- A total of 2153 medical records were reviewed, with an overall mean PPV of 88%.
- High PPVs (≥90%) were observed for numerous conditions including myocardial infarction, hypertension, and atrial fibrillation.
- PPVs varied by condition, with myocarditis showing the lowest PPV (64%).
Conclusions:
- Cardiovascular diagnoses in the DNPR demonstrate high overall validity.
- The DNPR data is considered sufficient for cardiovascular epidemiological research from 2010 onwards.
Objective:
The majority of cardiovascular diagnoses in the Danish National Patient Registry (DNPR) remain to be validated despite extensive use in epidemiological research. We therefore examined the positive predictive value (PPV) of cardiovascular diagnoses in the DNPR.
Design:
Population-based validation study.
Setting:
1 university hospital and 2 regional hospitals in the Central Denmark Region, 2010-2012.
Participants:
For each cardiovascular diagnosis, up to 100 patients from participating hospitals were randomly sampled during the study period using the DNPR.
Main Outcome Measure:
Using medical record review as the reference standard, we examined the PPV for cardiovascular diagnoses in the DNPR, coded according to the International Classification of Diseases, 10th Revision.
Results:
A total of 2153 medical records (97% of the total sample) were available for review. The PPVs ranged from 64% to 100%, with a mean PPV of 88%. The PPVs were ≥90% for first-time myocardial infarction, stent thrombosis, stable angina pectoris, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, takotsubo cardiomyopathy, arterial hypertension, atrial fibrillation or flutter, cardiac arrest, mitral valve regurgitation or stenosis, aortic valve regurgitation or stenosis, pericarditis, hypercholesterolaemia, aortic dissection, aortic aneurysm/dilation and arterial claudication. The PPVs were between 80% and 90% for recurrent myocardial infarction, first-time unstable angina pectoris, pulmonary hypertension, bradycardia, ventricular tachycardia/fibrillation, endocarditis, cardiac tumours, first-time venous thromboembolism and between 70% and 80% for first-time and recurrent admission due to heart failure, first-time dilated cardiomyopathy, restrictive cardiomyopathy and recurrent venous thromboembolism. The PPV for first-time myocarditis was 64%. The PPVs were consistent within age, sex, calendar year and hospital categories.
Conclusions:
The validity of cardiovascular diagnoses in the DNPR is overall high and sufficient for use in research since 2010.
Related Concept Videos
01:13Sensitivity, Specificity, and Predicted Value
Sensitivity is the...
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:30Acute Coronary Syndrome III: Diagnostic Studies