Table 2.
Positive predictive values (PPVs)* associated with inpatient administrative diagnosis codes for acute myocardial infarction (AMI) by position.
| PPVs for all potential AMI cases (N = 89) | PPVs for principal position AMI diagnoses (N = 30) | PPVs for secondary AMI diagnoses (N = 33) | PPVs for position-unspecified** AMI diagnoses (N = 26) | |
|---|---|---|---|---|
| All AMI codes | 75% (67/89, 95% CI: 65–84%) | 93% (28/30, 95% CI: 78–99%) | 88% (29/33, 95% CI: 72–97%) | 38% (10/26, 95% CI: 20–59%) |
| By diagnosis code recorded in administrative data | ||||
| 410.x0 | 33% (5/15, 95% CI: 12–62%) | 100% (1/1, 95% CI: 3–100%) | 33% (1/3, 95% CI: 1–91%) | 27% (3/11, 95% CI: 6–61%) |
| 410.x1 | 84% (62/74, 95% CI: 73–91%) | 93% (27/29, 95% CI: 77–99%) | 93% (28/30, 95% CI: 78–99%) | 47% (7/15, 95% CI: 21–73%) |
| Data Partner type | ||||
| Insurer/claims-based | 71% (49/69, 95% CI: 59–81%) | 92% (22/24, 95% CI: 73–99%) | 89% (17/19, 95% CI: 67–99%) | 38% (10/26, 95% CI: 20–59%) |
| Integrated care delivery systems | 90% (18/20, 95% CI: 68–99%) | 100% (6/6, 95% CI: 54–100%) | 86% (12/14, 95% CI: 57–98%) | -- |
| By whether an AMI code was observed in prior 183 days | ||||
| No prior AMI | 78% (54/69, 95% CI: 67–87%) | 92% (23/25, 95% CI: 74–99%) | 96% (22/23, 95% CI: 78–100%) | 43% (9/21, 95% CI: 22–66%) |
| Prior AMI | 65% (13/20, 95% CI: 41–85%) | 100% (5/5, 95% CI: 48–100%) | 70% (7/10, 95% CI: 35–93%) | 20% (1/5, 95% CI: 1–72%) |
*
Statistics reported in this table reflect the PPV of administrative ICD-9-CM AMI diagnosis codes for a confirmed (definite, probable, or possible) acute AMI. Patients with a classification of insufficient information / acute TEE status unknown were removed from the denominator for the PPV calculations and not included in this table.
**
Within the Sentinel Distributed Database, a position-unspecified inpatient diagnosis is a non-facility professional/provider claim associated with an inpatient encounter.