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Brief observation| Volume 129, ISSUE 2, P223-225, February 2016

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Administrative Data and the Philosopher's Stone: Turning Heart Failure Claims Data into Quantitative Assessment of Left Ventricular Ejection Fraction

Published:October 28, 2015DOI:https://doi.org/10.1016/j.amjmed.2015.10.003
Administrative Data and the Philosopher's Stone: Turning Heart Failure Claims Data into Quantitative Assessment of Left Ventricular Ejection Fraction
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      Abstract

      Background

      Administrative data are widely used in observational assessment of patient-centered clinical outcomes. In studies of cardiovascular outcomes, claims data are limited by lack of quantitative information, such as left ventricular ejection fraction. We aimed to determine whether left ventricular ejection fraction can be assessed from heart failure claims.

      Methods

      This observational, retrospective study used administrative and echocardiographic databases to identify heart failure patients (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 428.XX) who received echocardiograms. The study cohort included patients with at least one inpatient or outpatient claim for systolic (428.2X) or diastolic (428.3X) heart failure from January 1, 2007, through July 10, 2013, who received an echocardiogram within 30 days of the claim. Receiver operating characteristic (ROC) curves were used to determine the optimal left ventricular ejection fraction cut-off threshold between ICD-9-CM heart failure codes 428.2 (systolic) and 428.3 (diastolic). Bootstrapping was used to determine a 95% confidence interval for the best cut-off.

      Results

      A total of 2714 echocardiograms with ascertainable left ventricular ejection fraction were performed within 30 days of a heart failure diagnosis. ICD-9-CM codes 428.2 and 428.3 accounted for 28.9% and 18.2%, respectively, of all heart failure codes. The resulting ROC curve had a best threshold cut-off for ejection fractions of 43.5% (confidence interval 39.5%-44.5%). The area under the curve was 0.812, with positive predictive value 0.72 and negative predictive value 0.81.

      Conclusions

      Subject to study limitations, we conclude that assessing left ventricular ejection fraction using heart failure claims is possible.

      Keywords

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      References

      1. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Page 14. Available at: http://circ.ahajournals.org/content/early/2013/06/03/CIR.0b013e31829e8776.full.pdf+html. Accessed October 5, 2015.

        View in Article
        • Herzog C.A.
        Incidence of adverse events associated with use of perflutren contrast agents for echocardiography.
        JAMA. 2008; 299: 2023-2025
        View in Article
        • Robin X.
        • Turck N.
        • Hainard A.
        • et al.
        pROC: an open-source package for R and S+ to analyze and compare ROC curves.
        BMC Bioinformatics. 2011; 12: 77
        View in Article

      4. R version 3.1.0. April 10, 2014. Package pROC, version 1.8. May 5, 2015. Available at: https://cran.r-project.org/web/packages/pROC/pROC.pdf. Accessed October 5, 2015.

        View in Article

      Article info

      Publication history

      Published online: October 28, 2015

      Footnotes

      Funding: This study was supported by the Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota.

      Conflict of Interest: The authors have no conflicts of interest with its subject matter.

      Authorship: All authors had access to the data and a role in writing the manuscript.

      Identification

      DOI: https://doi.org/10.1016/j.amjmed.2015.10.003

      Copyright

      © 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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