Table 2.

Validity of NYC Macroscope Indicators by Practice^a

INDICATOR	ALL PRACTICES	NYC MACROSCOPE PRACTICESb	NON-NYC MACROSCOPE PRACTICES
			OVERALL	RESTRICTED TO STAGE 1 MEANINGFUL USEc
Obesity	N=159	N = 44	N=115	N = 72
Kappa	0.86	0.89	0.85	0.94
Sensitivity (95% CI)	0.91 (0.80, 0.97)	0.92 (0.64, 1.00)	0.91 (0.78, 0.97)	0.96 (0.80, 1.00)
Specificity (95% CI)	0.95 (0.89, 0.98)	0.97 (0.83, 1.00)	0.94 (0.86, 0.98)	0.98 (0.88, 1.00)
Smoking Status	N=151	N = 43	N=108	N=66
Kappa	0.85	1.00	0.79	0.83
Sensitivity (95% CI)	0.83 (0.63, 0.95)	1.00 (0.54, 1.00)	0.78 (0.52, 0.94)	0.90 (0.56, 1.00)
Specificity (95% CI)	0.98 (0.94, 1.00)	1.00 (0.91, 1.00)	0.98 (0.92, 1.00)	0.96 (0.88, 1.00)
Diabetes (diagnosis)	N=190	N=48	N=142	N=86
Kappa	0.82	0.87	0.80	0.81
Sensitivity (95% CI)	0.87 (0.69, 0.96)	1.00 (0.66, 1.00)	0.81 (0.58, 0.95)	0.83 (0.52, 0.98)
Specificity (95% CI)	0.97 (0.93, 0.99)	0.95 (0.83, 0.99)	0.98 (0.93, 0.99)	0.97 (0.91, 1.00)
Diabetes (augmented)d	N=178	N=45	N=133	N=82
Kappa	0.79	0.94	0.89	0.87
Sensitivity (95% CI)	0.94 (0.80, 0.99)	1.00 (0.69, 1.00)	0.91 (0.72, 0.99)	0.86 (0.57, 0.98)
Specificity (95% CI)	0.98 (0.94, 1.00)	0.97 (0.92, 1.00)	0.98 (0.94, 1.00)	0.99 (0.92, 1.00)
Hypertension (diagnosis)	N=190	N=48	N=142	N=86
Kappa	0.79	1.00	0.72	0.79
Sensitivity (95% CI)	0.84 (0.73, 0.92)	1.00 (0.78, 1.00)	0.79 (0.65, 0.89)	0.89 (0.72, 0.98)
Specificity (95% CI)	0.94 (0.89, 0.98)	1.00 (0.89, 1.00)	0.92 (0.85, 0.97)	0.91 (0.81, 0.97)
Hypertension (augmented)	N=190	N=48	N=142	N=86
Kappa	0.74	0.78	0.72	0.71
Sensitivity (95% CI)	0.84 (0.71, 0.89)	0.83 (0.59, 0.96)	0.80 (0.68, 0.89)	0.82 (0.65, 0.93)
Specificity (95% CI)	0.92 (0.85, 0.96)	0.93 (0.78, 0.99)	0.91 (0.83, 0.96)	0.88 (0.77, 0.96)
Hyperlipidemia (diagnosis)e	N=110	N=26	N=84	N=52
Kappa	0.30	0.31	0.30	0.23
Sensitivity (95% CI)	0.71 (0.58, 0.82)	0.69 (0.39, 0.91)	0.72 (0.57, 0.84)	0.70 (0.50, 0.86)
Specificity (95% CI)	0.59 (0.44, 0.72)	0.62 (0.32, 0.86)	0.58 (0.41, 0.74)	0.52 (0.31, 0.72)
Hyperlipidemia (augmented)d,e	N=103	N=23	N=80	N=50
Kappa	0.41	0.37	0.41	0.30
Sensitivity (95% CI)	0.80 (0.68, 0.89)	0.77 (0.46, 0.95)	0.81 (0.67, 0.91)	0.78 (0.58, 0.91)
Specificity (95% CI)	0.60 (0.43, 0.74)	0.60 (0.26, 0.88)	0.59 (0.41, 0.76)	0.52 (0.31, 0.73)

CI, confidence interval.

^aSample size varied by indicators within each practice type due to (1) missing data in charts (applicable to obesity and smoking only); and (2) non-response or missing data for height and weight, blood pressure, or laboratory values (for obesity and augmented indicators) in NYC HANES.

^bPreviously published [4,5].

^cRestricted to records from providers or practices that had attested for Stage 1 Meaningful Use as of December 31, 2013.

^dThe NYC Macroscope data were restricted to providers using an electronic lab interface for at least 10 patients, whereas data in the non-NYC Macroscope records were not.

^eRestricted to records from participants aged ≥40 years for men or ≥45 years for women at the time of NYC HANES interview.