A systematic review of validated methods for identifying ventricular arrhythmias using administrative and claims data

Abstract

Background Drug-induced pro-arrhythmia is a serious and unexpected event. Large administrative and claims databases can potentially identify drugs or interactions leading to cardiac arrhythmias. The purpose of this study is to evaluate the evidence supporting the validity of algorithms or codes to identify ventricular arrhythmias using administrative and claims data. Methods A search of MEDLINE database is supplemented by manual searches of bibliographies of key relevant articles. We selected all studies in which an administrative and claims data algorithm or code was validated against a medical record. We report the positive predictive value (PPV) for ICD-9 codes compared to medical records. Results Our search strategy yielded 664 studies, of which only seven met our eligibility criteria. Two additional studies were identified by peer reviewers. The most commonly included databases were Medicare and Medicaid, and the most commonly evaluated ICD-9 codes were 426.x and 427.x. The individual use of ICD-9 codes 427.x yielded a high PPV (78%-100%). The highest PPV was seen when both ICD-9 codes 427.x and 798.x were used (92%). The same codes yielded the highest PPV when found in the principal diagnosis position (100%). Conclusions The use of ICD-9 codes 427.x, alone or in combination with code 798.x, in the principal position is appropriate for the identification of ventricular arrhythmias in administrative and claims databases.

Macrolide antibiotics and the risk of ventricular arrhythmia in older adults

“…In previous studies assessing the accuracy of ICD-9 and ICD-10 codes for cardiac arrhythmia (ventricular and supraventricular), the positive predictive value (truly have the condition when code is present) exceeded 80%. [34][35][36][37] We performed a manual review of 202 charts in our region and confirmed a positive predictive value of 92% (95% confidence interval [CI] 87%-95%) for the set of codes used in this study to detect ventricular arrhythmia. Vital statistics for allcause mortality are coded accurately in our data sources, with a sensitivity of 97.8% and specificity of 100% for the finding of death.…”

Cardiovascular outcomes associated with use of clarithromycin: population based study

“…Similarly, some studies also reported a wide range of positive predictive values of cardiac arrhythmia or cardiac arrest in different databases. [33][34][35] …”

Factors predisposing to ventricular proarrhythmia during antiarrhythmic drug therapy for atrial fibrillation in patients with structurally normal heart

“…Potential incident events and all deaths were investigated in detail based on initial identification through International Classification of Diseases diagnostic codes and the database of the CCHIA, which was validated previously. [7][8][9][10] Part II: Clinical characteristics and occurrence of VT/VF in the single-center cohort This retrospective, longitudinal study included patients with symptomatic AF (European Heart Rhythm Association [EHRA] score II-IV) from the Taipei Veterans General Hospital from September 2002 to November 2013. Exclusion criteria were age o18 years or 480 years, previous implantation of pacemaker or defibrillator, presence of left atrial thrombus, active infection or sepsis, pregnancy, unstable angina, prior myocardial infarction, valvular heart disease, prior history of VT/VF, life expectation o12 months, mental disease, inability to follow-up, or coexisting diseases for which antiarrhythmic treatment was contraindicated.…”