Supplement 1: MedCode and ICD-10 codes for myocardial ...



Quality and completeness of myocardial infarction recording in CPRD AurumData SupplementContents TOC \o "1-3" \h \z \u Supplement 1: MedCode and ICD-10 codes for myocardial infarction PAGEREF _Toc71202238 \h 2Supplement 2: Sensitivity analyses: Concordance of recording of MI codes in CPRD Aurum compared with recordings in HES PAGEREF _Toc71202239 \h 5Supplement 3: Reasons MI diagnoses may have been recorded in CPRD Aurum but not recorded in HES PAGEREF _Toc71202240 \h 6Supplement 4: Reasons MI diagnoses may have been recorded in HES but not present in CPRD Aurum PAGEREF _Toc71202241 \h 7Supplement 5: Sensitivity analyses: Completeness of MI recording in CPRD Aurum estimated as the number of primary HES-coded MIs with strong supporting evidence also found in the CPRD Aurum patient records PAGEREF _Toc71202242 \h 9Supplement 1: MedCode and ICD-10 codes for myocardial infarctionCode Lists for Correctness AssessmentsCode TypeCodesCPRD AURUM CODESAcute MIMedCode (M-prefixed)M37443015HEART ATTACKM884151000006119MYOCARDIAL INFARCTIONM94884017ACUTE MYOCARDIAL INFARCTIONM256460011ECG: MYOCARDIAL INFARCT NOSM299707016OTHER SPECIFIED ANTERIOR MYOCARDIAL INFARCTIONM299708014ACUTE ANTEROAPICAL INFARCTIONM299709018ANTERIOR MYOCARDIAL INFARCTION NOSM299710011POSTERIOR MYOCARDIAL INFARCTION NOSM299711010LATERAL MYOCARDIAL INFARCTION NOSM299712015TRUE POSTERIOR MYOCARDIAL INFARCTIONM299714019INFERIOR MYOCARDIAL INFARCTION NOSM299718016OTHER ACUTE MYOCARDIAL INFARCTIONM299720018OTHER ACUTE MYOCARDIAL INFARCTION NOSM299721019ACUTE MYOCARDIAL INFARCTION NOSM1780491019ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTIONM1780501013ACUTE NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTIONM219521000000119ATTACK - HEARTM219531000000117MI - ACUTE MYOCARDIAL INFARCTIONM460681000006116ACUTE TRANSMURAL MYOCARDIAL INFARCTION OF UNSPECIF SITEM1790731000006117AMIM616081000006113DIAB MELLIT INSULIN-GLUCOSE INFUS ACUTE MYOCARDIAL INFARCTM1218860015ACUTE PAPILLARY MUSCLE INFARCTIONM1234005010ACUTE INFEROPOSTERIOR INFARCTIONM447324018ACUTE Q-WAVE INFARCTM450322013ACUTE NON-Q WAVE INFARCTIONM1234306015ACUTE SEPTAL INFARCTIONM455641000006112ACUTE ANTEROLATERAL INFARCTIONM455651000006114ACUTE ANTEROSEPTAL INFARCTIONM457531000006110ACUTE INFEROLATERAL INFARCTIONM116992017ACUTE SUBENDOCARDIAL INFARCTIONM299719012ACUTE ATRIAL INFARCTIONHES CODESAcute MI ICD-10I21* ACUTE MYOCARDIAL INFARCTION Subsequent MIICD-10I22*SUBSEQUENT ST ELEVATION (STEMI) AND NON-ST ELEVATION (NSTEMI)MYOCARDIAL INFARCTIONComplications following MIICD-10I23*CERTAIN CURRENT COMPLICATIONS FOLLOWING ST ELEVATION (STEMI) AND NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION (WITHIN THE 28-DAY PERIOD)I24.1DRESSLER'S SYNDROMEOld myocardial infarctionICD-10I25.2 OLD MYOCARDIAL INFARCTIONSilent myocardial infarctionICD-10I25.6 SILENT MYOCARDIAL ISCHEMIACode Lists for Completeness AssessmentsCode TypeCodesHES CODESAcute MI ICD-10I21* ACUTE MYOCARDIAL INFARCTION CPRD AURUM CODESAcute MIMedCode (M-prefixed)M37443015HEART ATTACKM884151000006119MYOCARDIAL INFARCTIONM94884017ACUTE MYOCARDIAL INFARCTIONM256460011ECG: MYOCARDIAL INFARCT NOSM299707016OTHER SPECIFIED ANTERIOR MYOCARDIAL INFARCTIONM299708014ACUTE ANTEROAPICAL INFARCTIONM299709018ANTERIOR MYOCARDIAL INFARCTION NOSM299710011POSTERIOR MYOCARDIAL INFARCTION NOSM299711010LATERAL MYOCARDIAL INFARCTION NOSM299712015TRUE POSTERIOR MYOCARDIAL INFARCTIONM299714019INFERIOR MYOCARDIAL INFARCTION NOSM299718016OTHER ACUTE MYOCARDIAL INFARCTIONM299720018OTHER ACUTE MYOCARDIAL INFARCTION NOSM299721019ACUTE MYOCARDIAL INFARCTION NOSM1780491019ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTIONM1780501013ACUTE NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTIONM219521000000119ATTACK - HEARTM219531000000117MI - ACUTE MYOCARDIAL INFARCTIONM460681000006116ACUTE TRANSMURAL MYOCARDIAL INFARCTION OF UNSPECIF SITEM1790731000006117AMIM616081000006113DIAB MELLIT INSULIN-GLUCOSE INFUS ACUTE MYOCARDIAL INFARCTM1218860015ACUTE PAPILLARY MUSCLE INFARCTIONM1234005010ACUTE INFEROPOSTERIOR INFARCTIONM447324018ACUTE Q-WAVE INFARCTM450322013ACUTE NON-Q WAVE INFARCTIONM1234306015ACUTE SEPTAL INFARCTIONM455641000006112ACUTE ANTEROLATERAL INFARCTIONM455651000006114ACUTE ANTEROSEPTAL INFARCTIONM457531000006110ACUTE INFEROLATERAL INFARCTIONM116992017ACUTE SUBENDOCARDIAL INFARCTIONM299719012ACUTE ATRIAL INFARCTIONPost-operative myocardial infarctionMedCode (M-prefixed)M208365015POSTOPERATIVE MYOCARDIAL INFARCTIONM455422014POSTOPERATIVE SUBENDOCARDIAL MYOCARDIAL INFARCTIONM455423016POSTOPERATIVE MYOCARDIAL INFARCTION, UNSPECIFIEDM212061000006119POSTOPERATIVE TRANSMURAL MYOCARDIAL INFARCTION ANTERIOR WALLM212071000006114POSTOPERATIVE TRANSMURAL MYOCARDIAL INFARCTION INFERIOR WALLM212081000006112POSTOPERATIVE TRANSMURAL MYOCARDIAL INFARCTION OTHER SITESM212091000006110POSTOPERATIVE TRANSMURAL MYOCARDIAL INFARCTION UNSPEC SITESubsequent myocardial infarctionMedCode (M-prefixed)M299808017SUBSEQUENT MYOCARDIAL INFARCTIONM299811016SUBSEQUENT MYOCARDIAL INFARCTION OF ANTERIOR WALLM299812011SUBSEQUENT MYOCARDIAL INFARCTION OF INFERIOR WALLM299813018SUBSEQUENT MYOCARDIAL INFARCTION OF OTHER SITESM118831000006118SUBSEQUENT MYOCARDIAL INFARCTION OF UNSPECIFIED SITEHistory of myocardial infarctionMedCode (M-prefixed)M4031011OLD MYOCARDIAL INFARCTIONM4032016HEALED MYOCARDIAL INFARCTIONM109915012POSTMYOCARDIAL INFARCTION SYNDROMEM230021000006115PERSONAL HISTORY OF MYOCARDIAL INFARCTIONSequalae of myocardial infarctionMedCode (M-prefixed)M458410010POST INFARCT ANGINAM67081000006119VENTRIC SEPTAL DEFECT/CURR COMP FOL ACUT MYOCARDAL INFARCTNM100681000006116THROMBOSIS ATRIUM,AURIC APPEND&VENT/CURR COMP FOLL ACUTE MIM158601000006116RUPTUR CARDIAC WALL W'OUT HAEMOPERICARD/CUR COMP FOL AC MIM158611000006118RUPTUR CHORDAE TENDINAE/CURR COMP FOL ACUTE MYOCARD INFARCTM159001000006119RUPTURE PAPILLARY MUSCLE/CURR COMP FOL ACUTE MYOCARD INFARCTM216351000006118POST INFARCTION PERICARDITISM498031000006112ATRIAL SEPTAL DEFECT/CURR COMP FOLOW ACUT MYOCARDAL INFARCTM537751000006115CARDIAC RUPTURE FOLLOWING MYOCARDIAL INFARCTION (MI)M543291000006110CERTAIN CURRENT COMPLICATION FOLLOW ACUTE MYOCARDIAL INFARCTM109916013DRESSLER'S SYNDROME Silent or micro myocardial infarctionMedCode (M-prefixed)M1229885017MICROINFARCTION OF HEARTM350376014SILENT MYOCARDIAL INFARCTIONSuspected or aborted myocardial infarctionMedCode (M-prefixed)M461192018[V]OBSERVATION FOR SUSPECTED MYOCARDIAL INFARCTIONM2619484018MI - MYOCARDIAL INFARCTION ABORTEDM682481000006118MYOCARDIAL INFARCTION ABORTEDSupplement 2: Sensitivity analyses: Concordance of recording of MI codes in CPRD Aurum compared with recordings in HES AnalysisN with CPRD Aurum-coded MIConcordant with HESConcordant diagnosis and timing*, N (%)Concordant diagnosis only?, N (%)Main analysis 1260986 (78)1109 (88)Concordance with HES with 30-day window1260952 (76)1109 (88)Concordance with HES at any time in record§12601123 (89)1123 (89)Diagnoses recorded in 2005 or later785667 (85)712 (91)Excluding patients with CPRD Aurum-coded MI within 30 days of death?1176938 (80)1060 (90)Excluding patients with CPRD Aurum-coded MI within 30 days of the end of follow-up1158924 (80)1045 (90)* Number of patients with a HES acute MI diagnosis code or old MI diagnosis within 90 days of first CPRD Aurum-coded MI ? Number of patients with a HES acute MI diagnosis code or old MI diagnosis concordant with the patient’s CPRD Aurum-coded MI, regardless of timing (see methods)§ Includes infrequent cases such as acute MI recorded in HES multiple years after MI recorded in CPRD Aurum? Deaths as recorded in CPRD Aurum. These data may be incomplete.Supplement 3: Reasons MI diagnoses may have been recorded in CPRD Aurum but not recorded in HES * N=13 unsatisfactory HES records were recorded before 2005? N=12 records with a procedure code for stent, bypass or angioplasty also included a diagnosis code for unstable angina or acute coronary syndromeThere were 60 patients for whom the HES record may have been an imperfect or incomplete reference standard: 35 patients died within 30 days of the MI recorded in CPRD Aurum, 10 patients had no HES data within 3 years of the CPRD Aurum MI despite serious medical conditions, and 15 patients’ HES records were unsatisfactory for research purposes (e.g., the HES record corresponding to the CPRD Aurum-coded MI by date lists a single ICD-10 diagnosis code “R69.6 illness, unspecified”). Of those with unsatisfactory HES records, all but two were recorded before 2005. A second group of 45 patients had HES records with other diagnoses and/or procedures for serious cardiovascular disease (CVD) at the time of the CPRD Aurum MI diagnosis code: 15 patients had a MI-related procedure (e.g., coronary artery bypass graft, stent insertion, or angioplasty), 15 patients had a diagnosis of unstable angina or acute coronary syndrome without a major procedure, and 15 patients had diagnoses for other major CVD such as congestive heart failure, arrhythmias or cardiac arrest. The final group of 46 patients had no relevant codes in HES at the time of the CPRD Aurum diagnosis. Of these, 11 patients had diagnoses for other major non-CVD conditions (e.g., cancer) which suggests that MI may not have been the chief medical concern in the HES record. The remaining 35 patient records had no major diagnoses in HES near the time of the CPRD Aurum-coded MI (8 of which were recorded on January 1). Supplement 4: Reasons MI diagnoses may have been recorded in HES but not present in CPRD Aurum ACS = acute coronary syndrome, Dx = diagnosis* CPRD Aurum records with very few diagnosis codes at any time despite having many drug prescriptions, lab entries and codes for scanned documents? CPRD Aurum record only contained a total of one code in the entire record, had a long gap in coding at the time of the HES MI, or the MI was miscodedWe explored the reasons why a MI diagnosis code may not have been recorded in 307 patients with a primary HES diagnosis of MI and no corresponding diagnosis in CPRD Aurum. A large number of these patients died within 30 days of the HES-coded MI (N=96). Another considerable number of patients (N=73) had codes indicating that the GP’s electronic record likely contained clinical information but it was coded in a way that was unavailable to researchers (e.g., information in free text fields) or the patients’ electronic records were otherwise unsuitable for research. These reasons included 40 patients with a code in CPRD Aurum indicating the GP had received clinical information at the time of the patient’s hospitalization (e.g., “attachment”, “scanned document”) but where no diagnoses were coded, 11 patients with codes indicating issues with data integrity at the time of the HES-coded MI (1572871000006117 “Awaiting clinical code migration to EMIS Web”), and 22 patients with CPRD Aurum records that had very few diagnosis codes at any time despite having many drug prescriptions, lab entries and codes for scanned documents. A few HES-coded MIs not found in CPRD Aurum were recorded near the beginning or end of the patient’s registration with the practice (N=16). A small number of CPRD Aurum records missing a MI diagnosis code contained only one code of any kind in the entire record, had a long gap in CPRD Aurum coding at the time of the HES-coded MI, or the MI was miscoded in CPRD Aurum (N=3). There was also a small group of patients (N=8) who had serious non-CVD diagnoses such as cancer or serious infection at the time of the HES-coded MI; thus, MI may not have been the chief medical concern for these patients.The remaining 111 CPRD Aurum records had diagnoses, procedure, or referral codes that indicated the presence of serious CVD but did not include a MI diagnosis code. The GP coded a stent, bypass or angioplasty at the time of the HES-coded MI in 42 patient records, acute coronary syndrome or unstable angina in 16 records, and other serious CVD, such as ischemic heart disease, congestive heart failure, arrhythmias, or cardiac arrest in 46 records. In many of these records, the GP also coded coronary/cardiac imaging, cardiology referrals or cardiac rehabilitation. Lastly, there were 7 records with MI codes in HES that were likely rule-out diagnoses: these MI codes were recorded in HES along with diagnostic procedures without an overnight hospital stay. In most of these cases, the GP coded the diagnostic procedure and/or a cardiology referral.Supplement 5: Sensitivity analyses: Completeness of MI recording in CPRD Aurum estimated as the number of primary HES-coded MIs with strong supporting evidence also found in the CPRD Aurum patient recordsN with a primary HES-coded MI with strong supporting evidence in either data source *N (%) present in CPRD Aurum ?Main analysis 1125880 (78)Present in CPRD Aurum within 30-day window1125849 (75)Present at any time in CPRD Aurum record§ 1125900 (80)Diagnoses recorded in 2005 or later740581 (79)Excluding patients with HES-coded MI within 30 days of death?989845 (85)Excluding patients with HES-coded MI within 30 days of end of follow-up974833 (86)* HES-coded MIs with strong evidence of MI based on procedures, referrals, prescriptions or other supporting clinical codes in either data source.? Number of patients with a CPRD Aurum MI diagnosis code within 90 days of the primary HES-coded MI § Includes infrequent situations such as acute MI recorded in HES multiple years after MI recorded in CPRD Aurum.? Deaths as recorded in CPRD Aurum. These data may be incomplete. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download