Table 2:
Performance of heart failure computable phenotype algorithms in the sub-population of patients who had NT-proBNP measured compared to validated heart failure in Olmsted County, Minnesota, 2010– 2012 (N=3,230)
| Sensitivity | Specificity | PPY | NPY | |||||
|---|---|---|---|---|---|---|---|---|
| Algorithm | Rate | % | Rate | % | Rate | % | Rate | % |
| Elevated NT-proBNP* | 1178/133 5 |
88 .2 |
1178/189 5 |
62 .2 |
1178/189 5 |
62 .2 |
1178/133 5 |
88 .2 |
| ≥1 HF codet† | 1267/133 5 |
94 .9 |
1502/189 5 |
79 .3 |
1267/166 0 |
76 .3 |
1502/157 0 |
95 .7 |
| ≥1 HF code + any HF medication‡ |
1141/133 5 |
85 .5 |
1586/189 5 |
83 .7 |
1141/145 0 |
78 .7 |
1586/178 0 |
89 .1 |
| ≥1 HF code + elevated NT- proBNP |
1136/133 5 |
85 .1 |
1618/189 5 |
85 .4 |
1136/141 3 |
80 .4 |
1618/181 7 |
89 .0 |
| ≥1 HF code + any HF medication + elevated NT- proBNP |
1018/133 5 |
76 .3 |
1679/189 5 |
88 .6 |
1018/123 4 |
82 .5 |
1679/199 6 |
84 .1 |
| ≥2 HF codes | 1073/133 5 |
80 .4 |
1665/189 5 |
87 .9 |
1073/130 3 |
82 .3 |
165/192 7 |
86 .4 |
| ≥2 HF codes + any HF medication |
1000/133 5 |
74 .9 |
1696/189 5 |
89 .5 |
1000/119 9 |
83 .4 |
1696/203 1 |
83 .5 |
| ≥2 HF codes + elevated NT- proBNP |
984/1335 | 73 .7 |
1726/189 5 |
91 .1 |
984/1153 | 85 .3 |
1726/207 7 |
83 .1 |
| ≥2 HF codes + any HF medication + elevated NT- proBNP |
916/1335 | 68 .6 |
1752/189 5 |
92 .5 |
916/1059 | 86 .5 |
1752/217 1 |
80 .7 |
| ≥1 inpatient or >2 outpatient HF codes |
1220/133 5 |
91 .4 |
1574/189 5 |
83 .1 |
1220/154 1 |
79 .2 |
1574/168 9 |
93 .2 |
| ≥1 mpatient or >2 outpatient HF codes + any HF medication |
1098/133 5 |
82 .2 |
1642/189 5 |
86 .6 |
1098/135 1 |
81 .3 |
1642/187 9 |
87 .4 |
| ≥1 inpatient or >2 outpatient codes + elevated NT-proBNP |
1116/133 5 |
83 .6 |
1656/189 5 |
87 .4 |
1116/135 5 |
82 .4 |
1656/187 5 |
88 .3 |
| ≥1 inpatient or >2 outpatient codes + any HF medication + elevated NT-proBNP |
1000/133 5 |
74 .9 |
1712/189 5 |
90 .3 |
1000/118 3 |
84 .5 |
1712/204 7 |
83 .6 |
Elevated NT-proBNP criteria defined as >450 pg/mL; those who did not have NT-proBNP measured or had NT-proBNP <450 pg/mL did not meet this criteria.
Heart failure code is International Classification of Diseases – 9th Revision, Clinical Modification code 428.
Heart failure medications include aldosterone antagonists (eplerenone, spironolactone), HF specific beta blockers (bisoprolol, carvedilol, metoprolol succinate), loop diuretics (bumetanide, ethacrynic acid, furosemide, torsemide), digoxin, angiotensin converting enzyme inhibitors and angiotensin receptor blockers.
HF, heart failure; NPV, negative predictive value; NT-proBNP, N-terminal B-type natriuretic peptide; PPV, positive predictive value.