Table 3.
Reasons for False-Negative and False-Positive Identification of STEMI, NSTEMI and AMI by the Best Algorithms
| Diagnosis | Reason | n |
|---|---|---|
| STEMI | False negatives for algorithm B | 52 |
| STEMI codes listed in the 4th or 5th diagnosis fields | 17 | |
| Miscoded as atherosclerotic heart disease of native coronary artery (I25.1X) | 16 | |
| Coded as comorbidities or underlying diseases instead of STEMI | 14 | |
| Miscoded as acute ischemic heart diseases, unspecified (I24.9) | 5 | |
| False positives for algorithm B | 90 | |
| NSTEMI miscoded as STEMI | 58 | |
| Unstable angina miscoded as STEMI | 22 | |
| Suspected coronary artery disease without coronary angiography confirmation | 9 | |
| Coronary artery disease with chronic stable angina miscoded as STEMI | 1 | |
| NSTEMI | False negatives for algorithm C | 295 |
| Coded as comorbidities or underlying diseases instead of NSTEMI | 153 | |
| Miscoded as atherosclerotic heart disease of native coronary artery (I25.1X) | 70 | |
| Miscoded as STEMI | 56 | |
| Miscoded as acute ischemic heart diseases, unspecified (I24.9) | 15 | |
| Miscoded as subsequent NSTEMI (I22.2) | 1 | |
| False positives for algorithm C | 51 | |
| Unstable angina miscoded as NSTEMI | 29 | |
| Suspected coronary artery disease without coronary angiography confirmation | 18 | |
| STEMI miscoded as NSTEMI | 2 | |
| Coronary artery disease with chronic stable angina miscoded as NSTEMI | 1 | |
| Negative coronary angiography finding miscoded as NSTEMI | 1 | |
| AMI | False negatives for algorithm C | 265 |
| Coded as comorbidities or underlying diseases instead of STEMI or NSTEMI | 160 | |
| Miscoded as atherosclerotic heart disease of native coronary artery (I25.1X) | 84 | |
| Miscoded as acute ischemic heart diseases, unspecified (I24.9) | 20 | |
| Miscoded as subsequent NSTEMI (I22.2) | 1 | |
| False positives for algorithm C | 104 | |
| Unstable angina miscoded as STEMI or NSTEMI | 62 | |
| Suspected coronary artery disease without coronary angiography confirmation | 35 | |
| Negative coronary angiography finding miscoded as STEMI or NSTEMI | 5 | |
| Coronary artery disease with chronic stable angina miscoded as NSTEMI | 2 |
Abbreviations: AMI, acute myocardial infarction; STEMI, ST-elevation myocardial infarction; NSTEMI, non-ST-elevation myocardial infarction.