A systematic review of validated methods for identifying atrial fibrillation using administrative data

Pharmacoepidemiology and Drug Safety - Tập 21 Số S1 - Trang 141-147 - 2012
Paul N. Jensen1,2, Karin Johnson3, James S. Floyd1,2, Susan R. Heckbert1,4,3, Ryan M. Carnahan5, Sascha Dublin2,3
1Cardiovascular Health Research Unit, Seattle, WA, USA
2Department of Epidemiology; University of Washington; Seattle WA USA
3Group Health Research Institute, Seattle, WA, USA
4Department of Epidemiology, University of Washington, Seattle, WA, USA
5Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA

Tóm tắt

ABSTRACTPurposeThe objectives of this study were to characterize the validity of algorithms to identify AF from electronic health data through a systematic review of the literature and to identify gaps needing further research.MethodsTwo reviewers examined publications during 1997–2008 that identified patients with atrial fibrillation (AF) from electronic health data and provided validation information. We abstracted information including algorithm sensitivity, specificity, and positive predictive value (PPV).ResultsWe reviewed 544 abstracts and 281 full‐text articles, of which 18 provided validation information from 16 unique studies. Most used data from before 2000, and 10 of 16 used only inpatient data. Three studies incorporated electronic ECG data for case identification or validation. A large proportion of prevalent AF cases identified by ICD‐9 code 427.31 were valid (PPV 70%–96%, median 89%). Seven studies reported algorithm sensitivity (range, 57%–95%, median 79%). One study validated an algorithm for incident AF and reported a PPV of 77%.ConclusionsThe ICD‐9 code 427.31 performed relatively well, but conclusions about algorithm validity are hindered by few recent data, use of nonrepresentative populations, and a disproportionate focus on inpatient data. An optimal contemporary algorithm would likely draw on inpatient and outpatient codes and electronic ECG data. Additional research is needed in representative, contemporary populations regarding algorithms that identify incident AF and incorporate electronic ECG data. Copyright © 2012 John Wiley & Sons, Ltd.

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Pharmacoepidemiology and Drug Safety

Tập 21 Số S1

141-147

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