Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study
Abstract Background Cardiovascular death is a common outcome in population-based studies about new healthcare interventions or treatments, such as new prescription medications. Vital statistics registration systems are often the preferred source of information about cause-specific mortality because...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-07-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-021-06762-0 |
| _version_ | 1818909196211453952 |
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| author | Lisa M. Lix Shamsia Sobhan Audray St-Jean Jean-Marc Daigle Anat Fisher Oriana H. Y. Yu Sophie Dell’Aniello Nianping Hu Shawn C. Bugden Baiju R. Shah Paul E. Ronksley Silvia Alessi-Severini Antonios Douros Pierre Ernst Kristian B. Filion |
| author_facet | Lisa M. Lix Shamsia Sobhan Audray St-Jean Jean-Marc Daigle Anat Fisher Oriana H. Y. Yu Sophie Dell’Aniello Nianping Hu Shawn C. Bugden Baiju R. Shah Paul E. Ronksley Silvia Alessi-Severini Antonios Douros Pierre Ernst Kristian B. Filion |
| author_sort | Lisa M. Lix |
| collection | DOAJ |
| description | Abstract Background Cardiovascular death is a common outcome in population-based studies about new healthcare interventions or treatments, such as new prescription medications. Vital statistics registration systems are often the preferred source of information about cause-specific mortality because they capture verified information about the deceased, but they may not always be accessible for linkage with other sources of population-based data. We assessed the validity of an algorithm applied to administrative health records for identifying cardiovascular deaths in population-based data. Methods Administrative health records were from an existing multi-database cohort study about sodium-glucose cotransporter-2 (SGLT2) inhibitors, a new class of antidiabetic medications. Data were from 2013 to 2018 for five Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, Quebec) and the United Kingdom (UK) Clinical Practice Research Datalink (CPRD). The cardiovascular mortality algorithm was based on in-hospital cardiovascular deaths identified from diagnosis codes and select out-of-hospital deaths. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the cardiovascular mortality algorithm using vital statistics registrations as the reference standard. Overall and stratified estimates and 95% confidence intervals (CIs) were computed; the latter were produced by site, location of death, sex, and age. Results The cohort included 20,607 individuals (58.3% male; 77.2% ≥70 years). When compared to vital statistics registrations, the cardiovascular mortality algorithm had overall sensitivity of 64.8% (95% CI 63.6, 66.0); site-specific estimates ranged from 54.8 to 87.3%. Overall specificity was 74.9% (95% CI 74.1, 75.6) and overall PPV was 54.5% (95% CI 53.7, 55.3), while site-specific PPV ranged from 33.9 to 72.8%. The cardiovascular mortality algorithm had sensitivity of 57.1% (95% CI 55.4, 58.8) for in-hospital deaths and 72.3% (95% CI 70.8, 73.9) for out-of-hospital deaths; specificity was 88.8% (95% CI 88.1, 89.5) for in-hospital deaths and 58.5% (95% CI 57.3, 59.7) for out-of-hospital deaths. Conclusions A cardiovascular mortality algorithm applied to administrative health records had moderate validity when compared to vital statistics data. Substantial variation existed across study sites representing different geographic locations and two healthcare systems. These variations may reflect different diagnostic coding practices and healthcare utilization patterns. |
| first_indexed | 2024-12-19T22:23:04Z |
| format | Article |
| id | doaj.art-c498e39bd3c644369e0c1baf1364ede1 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-19T22:23:04Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-c498e39bd3c644369e0c1baf1364ede12022-12-21T20:03:35ZengBMCBMC Health Services Research1472-69632021-07-0121111110.1186/s12913-021-06762-0Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort studyLisa M. Lix0Shamsia Sobhan1Audray St-Jean2Jean-Marc Daigle3Anat Fisher4Oriana H. Y. Yu5Sophie Dell’Aniello6Nianping Hu7Shawn C. Bugden8Baiju R. Shah9Paul E. Ronksley10Silvia Alessi-Severini11Antonios Douros12Pierre Ernst13Kristian B. Filion14Department of Community Health Sciences, University of ManitobaDepartment of Community Health Sciences, University of ManitobaCenter for Clinical Epidemiology, Lady Davis Institute, Jewish General HospitalInstitut national d’excellence en santé et en services sociaux (INESSS)Department of Anesthesiology, Pharmacology and Therapeutics, University of British ColumbiaCenter for Clinical Epidemiology, Lady Davis Institute, Jewish General HospitalCenter for Clinical Epidemiology, Lady Davis Institute, Jewish General HospitalThe Health Quality CouncilCollege of Pharmacy, Rady Faculty of Health Sciences, University of ManitobaICESDepartment of Community Health Sciences, Cumming School of Medicine, University of CalgaryCollege of Pharmacy, Rady Faculty of Health Sciences, University of ManitobaCenter for Clinical Epidemiology, Lady Davis Institute, Jewish General HospitalCenter for Clinical Epidemiology, Lady Davis Institute, Jewish General HospitalCenter for Clinical Epidemiology, Lady Davis Institute, Jewish General HospitalAbstract Background Cardiovascular death is a common outcome in population-based studies about new healthcare interventions or treatments, such as new prescription medications. Vital statistics registration systems are often the preferred source of information about cause-specific mortality because they capture verified information about the deceased, but they may not always be accessible for linkage with other sources of population-based data. We assessed the validity of an algorithm applied to administrative health records for identifying cardiovascular deaths in population-based data. Methods Administrative health records were from an existing multi-database cohort study about sodium-glucose cotransporter-2 (SGLT2) inhibitors, a new class of antidiabetic medications. Data were from 2013 to 2018 for five Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, Quebec) and the United Kingdom (UK) Clinical Practice Research Datalink (CPRD). The cardiovascular mortality algorithm was based on in-hospital cardiovascular deaths identified from diagnosis codes and select out-of-hospital deaths. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the cardiovascular mortality algorithm using vital statistics registrations as the reference standard. Overall and stratified estimates and 95% confidence intervals (CIs) were computed; the latter were produced by site, location of death, sex, and age. Results The cohort included 20,607 individuals (58.3% male; 77.2% ≥70 years). When compared to vital statistics registrations, the cardiovascular mortality algorithm had overall sensitivity of 64.8% (95% CI 63.6, 66.0); site-specific estimates ranged from 54.8 to 87.3%. Overall specificity was 74.9% (95% CI 74.1, 75.6) and overall PPV was 54.5% (95% CI 53.7, 55.3), while site-specific PPV ranged from 33.9 to 72.8%. The cardiovascular mortality algorithm had sensitivity of 57.1% (95% CI 55.4, 58.8) for in-hospital deaths and 72.3% (95% CI 70.8, 73.9) for out-of-hospital deaths; specificity was 88.8% (95% CI 88.1, 89.5) for in-hospital deaths and 58.5% (95% CI 57.3, 59.7) for out-of-hospital deaths. Conclusions A cardiovascular mortality algorithm applied to administrative health records had moderate validity when compared to vital statistics data. Substantial variation existed across study sites representing different geographic locations and two healthcare systems. These variations may reflect different diagnostic coding practices and healthcare utilization patterns.https://doi.org/10.1186/s12913-021-06762-0AccuracyCause-specific mortalityDeath certificatesHospital recordsPhysician claimsValidation |
| spellingShingle | Lisa M. Lix Shamsia Sobhan Audray St-Jean Jean-Marc Daigle Anat Fisher Oriana H. Y. Yu Sophie Dell’Aniello Nianping Hu Shawn C. Bugden Baiju R. Shah Paul E. Ronksley Silvia Alessi-Severini Antonios Douros Pierre Ernst Kristian B. Filion Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study BMC Health Services Research Accuracy Cause-specific mortality Death certificates Hospital records Physician claims Validation |
| title | Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study |
| title_full | Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study |
| title_fullStr | Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study |
| title_full_unstemmed | Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study |
| title_short | Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study |
| title_sort | validity of an algorithm to identify cardiovascular deaths from administrative health records a multi database population based cohort study |
| topic | Accuracy Cause-specific mortality Death certificates Hospital records Physician claims Validation |
| url | https://doi.org/10.1186/s12913-021-06762-0 |
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