Table 3.
Positive Predictive Values of Medicare Inpatient Claims for Identifying Myocardial Infarctions Adjudicated Through REasons for Geographic And Racial Differences in Stroke Study Procedures.
| Characteristics | Number of Medicare claims with a discharge diagnosis code for MI in any position | Adjudicated as definite or probable MI in REGARDS | Number of Medicare claims with a discharge diagnosis code for MI in the primary position | Adjudicated as definite or probable MI in REGARDS | ||||
|---|---|---|---|---|---|---|---|---|
| n | PPV (95% CI) | p-value* | n | PPV (95% CI) | p-value* | |||
| Full population | 523 | 441 | 84.3 (80.9–87.3) | 398 | 357 | 89.7 (86.3–92.5) | ||
| Age | ||||||||
| <75 years | 309 | 266 | 86.1 (81.7–89.7) | 0.18 | 236 | 213 | 90.3 (85.7–93.7) | 0.66 |
| ≥75 years | 214 | 175 | 81.8 (75.9–86.7) | 162 | 144 | 88.9 (83.0–93.3) | ||
| Sex | ||||||||
| Women | 215 | 175 | 81.4 (75.5–86.4) | 0.12 | 161 | 139 | 86.3 (80.0–91.2) | 0.07 |
| Men | 308 | 266 | 86.4 (82.0–90.0) | 237 | 218 | 92.0 (87.8–95.1) | ||
| Race | ||||||||
| White | 364 | 313 | 86.0 (82.0–89.4) | 0.11 | 281 | 254 | 90.4 (86.3–93.6) | 0.48 |
| Black | 159 | 128 | 80.5 (73.5–86.4) | 117 | 103 | 88.0 (80.7–93.3) | ||
| Geographic region of residence† | ||||||||
| Stroke buckle | 121 | 104 | 86.0 (78.5–91.6) | (ref) | 97 | 87 | 89.7 (81.9–94.9) | (ref) |
| Stroke belt | 190 | 164 | 86.3 (80.6–90.9) | 0.93 | 142 | 132 | 93.0 (87.4–96.6) | 0.37 |
| Other contiguous US states | 212 | 173 | 81.6 (75.7–86.6) | 0.31 | 159 | 138 | 86.8 (80.5–91.6) | 0.49 |
| Calendar year | ||||||||
| 2003–2006 | 141 | 116 | 82.3 (74.9–88.2) | (ref) | 103 | 90 | 87.4 (79.4–93.1) | (ref) |
| 2007–2009 | 202 | 169 | 83.7 (77.8–88.5) | 0.73 | 160 | 140 | 87.5 (81.4–92.2) | 0.98 |
| 2010–2012 | 180 | 156 | 86.7 (80.8–91.3) | 0.28 | 135 | 127 | 94.1 (88.7–97.4) | 0.07 |
| Education | ||||||||
| Less than high school | 112 | 89 | 79.5 (70.8–86.5) | 0.09 | 78 | 70 | 89.7 (80.8–95.5) | 0.98 |
| High school or higher | 408 | 351 | 86.0 (82.3–89.2) | 319 | 286 | 89.7 (85.8–92.8) | ||
| Total annual household income | ||||||||
| <$25,000 | 192 | 155 | 80.7 (74.4–86.1) | 0.06 | 141 | 123 | 87.2 (80.6–92.3) | 0.16 |
| ≥$25,000 | 267 | 233 | 87.3 (82.7–91.0) | 208 | 191 | 91.8 (87.2–95.2) | ||
| Cognitive impairment | ||||||||
| No | 319 | 274 | 85.9 (81.6–89.5) | 0.12 | 250 | 224 | 89.6 (85.1–93.1) | 0.45 |
| Yes | 43 | 33 | 76.7 (61.4–88.2) | 34 | 29 | 85.3 (68.9–95.0) | ||
| History of CHD | ||||||||
| No | 272 | 240 | 88.2 (83.8–91.8) | 0.008 | 216 | 200 | 92.6 (88.2–95.7) | 0.03 |
| Yes | 246 | 196 | 79.7 (74.1–84.5) | 177 | 152 | 85.9 (79.9–90.6) | ||
Abbreviations: CHD, coronary heart disease; CI, confidence interval; MI, myocardial infarction; PPV, positive predictive value; REGARDS, REasons for Geographic And Racial Differences in Stroke.
P-values were calculated using the χ2 test.
Stroke buckle includes coastal plains of North Carolina, South Carolina and Georgia. Stroke belt includes the remaining parts of North Carolina, South Carolina and Georgia, and Tennessee, Mississippi, Alabama, Louisiana and Arkansas. Other contiguous US states includes the remaining 40 contiguous US states and the District of Columbia.