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Positive predictive value of cardiac examination, procedure and surgery codes in the Danish National Patient
Kasper Adelborg1,2, Jens Sundbøll1,2, Troels Munch1
1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Insights
Data quality for cardiac interventions in Danish registries is high. Positive predictive values (PPVs) for examinations, procedures, and surgeries were computed, showing excellent accuracy for cardiovascular research.
Area of Science:
- Cardiovascular research
- Health informatics
- Medical data quality
Background:
- Danish medical registries are valuable for cardiovascular research.
- Data quality of cardiac interventions in these registries is not well-established.
Purpose of the Study:
- To compute positive predictive values (PPVs) for cardiac examinations, procedures, and surgeries.
- To assess the data quality of registered cardiac interventions in the Danish National Patient Registry (DNPR) between 2010-2012.
Main Methods:
- A population-based validation study design was employed.
- 1239 patients undergoing various cardiac interventions were randomly sampled from three hospitals in the Central Denmark Region.
- Medical record review served as the reference standard for calculating PPVs.
Main Results:
- High PPVs were observed across all categories: 98% for examinations, 98% for procedures, and 99% for cardiac surgery.
- Specific PPVs included 97% for echocardiography, 98% for percutaneous coronary intervention, and 98% for coronary artery bypass graft surgery.
- Coding accuracy was consistent across demographic groups, with high inter-reviewer agreement (99%).
Conclusions:
- Cardiac examinations, procedures, and surgeries are recorded with high data quality in the Danish National Patient Registry.
- These findings support the continued use of the DNPR for robust cardiovascular research.
Objective:
Danish medical registries are widely used for cardiovascular research, but little is known about the data quality of cardiac interventions. We computed positive predictive values (PPVs) of codes for cardiac examinations, procedures and surgeries registered in the Danish National Patient Registry during 2010-2012.
Design:
Population-based validation study.
Setting:
We randomly sampled patients from 1 university hospital and 2 regional hospitals in the Central Denmark Region.
Participants:
1239 patients undergoing different cardiac interventions.
Main Outcome Measure:
PPVs with medical record review as reference standard.
Results:
A total of 1233 medical records (99% of the total sample) were available for review. PPVs ranged from 83% to 100%. For examinations, the PPV was overall 98%, reflecting PPVs of 97% for echocardiography, 97% for right heart catheterisation and 100% for coronary angiogram. For procedures, the PPV was 98% overall, with PPVs of 98% for thrombolysis, 92% for cardioversion, 100% for radiofrequency ablation, 98% for percutaneous coronary intervention, and 100% for both cardiac pacemakers and implantable cardiac defibrillators. For cardiac surgery, the overall PPVs was 99%, encompassing PPVs of 100% for mitral valve surgery, 99% for aortic valve surgery, 98% for coronary artery bypass graft surgery, and 100% for heart transplantation. The accuracy of coding was consistent within age, sex, and calendar year categories, and the agreement between independent reviewers was high (99%).
Conclusions:
Cardiac examinations, procedures and surgeries have high PPVs in the Danish National Patient Registry.
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