Table 2.
Assessment of Outcomes Using Claims Compared to Adjudicated Trial Data Using Different Coding Strategies in the EXTEND-CoreValve Study
| Outcome | Sensitivity (%) (95% CI) | Specificity (%) (95% CI) | PPV (%) (95% CI) | NPV (%) (95% CI) | Kappa (95% CI) |
|---|---|---|---|---|---|
| Major clinical endpoints (at 1 year) | |||||
| Aortic Valve Reintervention | |||||
| Comprehensive code set | 84.4 (70.5, 93.5) | 99.6 (99.4, 99.8) | 69.1 (57.8, 78.5) | 99.8 (99.7, 99.9) | 0.76 (0.66, 0.85) |
| Parsimonious code set | 75.6 (60.5, 87.1) | 99.8 (99.6, 99.9) | 79.1 (65.8, 88.1) | 99.7 (99.6, 99.8) | 0.77 (0.67, 0.87) |
| Myocardial Infarction | |||||
| Comprehensive code set | 63.6 (51.9, 74.3) | 97.2 (96.7, 97.7) | 29.9 (25.0, 35.3) | 99.3 (99.1, 99.5) | 0.39 (0.31, 0.47) |
| Parsimonious code set | 62.3 (50.6, 73.1) | 97.8 (97.3, 98.2) | 34.0 (28.4, 40.2) | 99.3 (99.1, 99.5) | 0.43 (0.34, 0.51) |
| Procedural outcomes (at 30 days) | |||||
| Permanent Pacemaker Implantation | |||||
| Comprehensive code set | 92.2 (90.1, 94.0) | 99.1 (98.8, 99.4) | 96.1 (94.5, 97.2) | 98.2 (97.7, 98.6) | 0.93 (0.91, 0.94) |
| Parsimonious code set | 91.8 (89.7, 93.6) | 99.3 (99.0, 99.6) | 96.8 (95.3, 97.8) | 98.1 (97.7, 98.5) | 0.93 (0.92, 0.94) |
| Acute Kidney Injury | |||||
| Comprehensive code set | 70.2 (65.9, 74.2) | 85.4 (84.2, 86.5) | 38.2 (36.0, 40.5) | 95.7 (95.1, 96.2) | 0.41 (0.37, 0.44) |
| Parsimonious code set | 25.6 (21.8, 29.7) | 98.1 (97.6, 98.5) | 63.0 (56.5, 69.1) | 91.1 (90.7, 91.5) | 0.32 (0.27, 0.37) |
| Bleeding | |||||
| Comprehensive code set | 86.4 (84.5, 88.2) | 36.8 (35.2, 38.4) | 35.0 (34.2, 35.7) | 87.3 (85.7, 88.8) | 0.16 (0.14, 0.18) |
| Parsimonious code set | 3.1 (2.2, 4.1) | 99.3 (99.0, 99.6) | 63.6 (51.6, 74.2) | 72.2 (72.0, 72.4) | 0.03 (0.02, 0.05) |
The parsimonious code set represents hospitalizations with events selected using an algorithm incorporating individual codes with perfect matching or with a likelihood ratio positive >10 for identifying adjudicated events. Test characteristics for parsimonious code set are adjusted for optimism through ten-fold cross validation. Sensitivity = (true positives)/(true positives + false negatives); specificity = (true negatives)/(true negatives + false positives); PPV = (true positives)/(true positives + false positives); NPV = (true negatives)/(true negatives + false negatives).
PPV=positive predictive value, NPV=negative predictive value, CI=confidence interval