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Completeness and correctness of acute myocardial infarction diagnoses in a medical quality register and an administrative health register.

Authors
  • Govatsmark, Ragna Elise Støre1, 2
  • Janszky, Imre1, 3
  • Slørdahl, Stig Arild2, 4
  • Ebbing, Marta5
  • Wiseth, Rune6, 7
  • Grenne, Bjørnar6, 7
  • Vesterbekkmo, Elisabeth6
  • Bønaa, Kaare Harald2, 6, 7, 8
  • 1 Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway. , (Norway)
  • 2 Department of Medical Quality Registers, St Olavs hospital, Trondheim University Hospital, Norway. , (Norway)
  • 3 Regional Center for Health Care Improvement, St Olavs hospital, Trondheim University Hospital, Norway. , (Norway)
  • 4 The Central Norway Regional Health Authority, Norway. , (Norway)
  • 5 Norwegian Institute of Public Health, Oslo, Norway. , (Norway)
  • 6 Clinic for Heart Disease, St Olavs hospital, Trondheim University Hospital, Norway. , (Norway)
  • 7 Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. , (Norway)
  • 8 Department of Community Medicine, University of Tromsø-The Arctic University of Norway, Tromsø, Norway. , (Norway)
Type
Published Article
Journal
Scandinavian journal of public health
Publication Date
Feb 01, 2020
Volume
48
Issue
1
Pages
5–13
Identifiers
DOI: 10.1177/1403494818803256
PMID: 30269654
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Aims: Health registers are used for administrative purposes, disease surveillance, quality assessment, and research. The value of the registers is entirely dependent on the quality of their data. The aim of this study was to investigate and compare the completeness and correctness of the acute myocardial infarction (AMI) diagnosis in the Norwegian Myocardial Infarction Register and in the Norwegian Patient Register. Methods: All Norwegian patients admitted directly to St Olavs hospital, Trondheim University Hospital, Trondheim University Hospital from 1 July to 31 December 2012 and who had plasma levels of cardiac troponin T measured during their hospitalization (n=4835 unique individuals, n=5882 hospitalizations) were identified in the hospital biochemical database. A gold standard for AMI was established by evaluation of maximum troponin T levels and by review of the information in the medical records. Cases of AMI in the registers were classified as true positive, false positive, true negative, and false negative according to the gold standard. We calculated sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV). Results: The Norwegian Myocardial Infarction Register had a sensitivity of 86.0% (95% confidence interval (CI) 82.8-89.3%), PPV of 97.9% (96.4-99.3%), and specificity of 99.9% and NPV of 98.9% (98.6-99.2%) (99.8-100%). The corresponding figures for the Norwegian Patient Register were 85.8% (95% CI 82.5-89.1%), 95.1% (92.9-97.2%), and 99.7% (99.5-99.8%) and 98.9% (98.6-99.2%), respectively. Both registers had a sensitivity higher than 95% when compared to hospital discharge diagnoses. The results were similar for men and women and for cases below and above 80 years of age. Conclusions: The Norwegian Myocardial Infarction Register and the Norwegian Patient Register are adequately complete and correct for administrative purposes, disease surveillance, quality assessment, and research.

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