Positive predictive value and misclassification of diagnosis of pulmonary embolism and deep vein thrombosis in Swedish patient registries

BackgroundThe Swedish Registry of Respiratory Failure (Swedevox) collects nationwide data on patients starting continuous positive airway pressure (CPAP) treatment, long-term mechanical ventilator (LTMV) and long-term oxygen therapy (LTOT). We validated key information in Swedevox against source data from medical records.MethodsThis was a retrospective validation study of patients starting CPAP (n=175), LTMV (n=177) or LTOT (n=175) across seven centres 2013–2017. Agreement with medical record data was analysed using differences in means (standard deviation) and proportion (%) of a selection of clinically relevant variables. Variables of interest included for CPAP: Apnea Hypopnea Index (AHI), height, weight, body mass index (BMI) and Epworth Sleepiness Scale (ESS) score; for LTMV: date of blood gas, PaCO2 (breathing air), weight and diagnosis group; and for LTOT: blood gases breathing air and oxygen, spirometry and main diagnosis.ResultsData on CPAP and LTOT had very high validity across all evaluated variables (all <5% discrepancy). For LTMV, variability was higher against source information for PaCO2 (>0.5 kPa in 25.9%), weight (>5 kg in 47.5%) and diagnosis group. Inconsistency was higher for patients starting LTMV acutely versus electively (PaCO2 –difference >0.5 kPa in 36% versus 21%, p<0.05, respectively). However, there were no signs of systematic bias (mean differences close to zero) across the evaluated variables.ConclusionValidity of Swedevox data, compared with medical records, was very high for CPAP, LTMV and LTOT. The large sample size and lack of systematic differences support that Swedevox data are valid for health care quality assessment and research.

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“…The findings of this study are in line with reported validations of other Swedish national registries [19][20][21].…”

Section: Discussionsupporting

confidence: 91%

Validation of the Swedevox registry of continuous positive airway pressure, long-term mechanical ventilator and long-term oxygen therapy

et al. 2020

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“…We have previously shown that non-validated ICD codes have a low (61-72%) positive predictive value for VTE. 36,37 We used the CAGE questionnaire to define alcohol dependence. 26 The CAGE questionnaire is used in clinical practice to identify persons with problem drinking, and has been validated in several studies.…”

Section: Discussionmentioning

confidence: 99%

Alcohol Consumption and Risk of First-Time Venous Thromboembolism in Men and Women

Johansson

Wennberg

et al. 2019

Thromb Haemost

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Background The relationship between alcohol intake and risk of venous thromboembolism (VTE) is unclear. Men and women differ in their drinking habits, which may affect a possible association. Objective This article investigates the association between alcohol consumption, alcohol dependence and VTE in the total population as well as in men and women separately. Methods We performed a prospective, population-based cohort study in northern Sweden. Study participants were 108,025 (51% women) persons aged 30 to 60 years who underwent a health examination between 1985 and 2014. We assessed alcohol consumption and defined alcohol dependence using a questionnaire. The outcome was a validated first-time VTE. Results The mean follow-up time was 13.9 years, and 2,054 participants had a first-time VTE. The mean alcohol consumption was 3.5 standard drinks weekly in men and 1.5 in women. Alcohol dependence was found in 10% of men and 3% of women. There was an association between alcohol consumption (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.00–1.03 per standard drink weekly) as well as alcohol dependence (HR, 1.27; 95% CI, 1.06–1.52) and VTE after adjustments. In men, the risk of VTE increased over quartiles of weekly alcohol consumption (p for trend 0.02), with a HR of 1.22 (95% CI, 1.01–1.47) for the highest quartile. Alcohol dependence was associated with VTE in men (HR, 1.30; 95% CI, 1.07–1.59). In women, there were no significant associations. Conclusion High alcohol consumption and alcohol dependence were associated with increased risk of first-time VTE in men, but not in women.

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“…We have previously shown that in Sweden, unvalidated ICD diagnostic codes for VTE have a low positive predictive value. 39…”

Section: Discussionmentioning

confidence: 99%

Physical activity and risk of first-time venous thromboembolism

Johansson

Wennberg

et al. 2019

Eur J Prev Cardiolog

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Positive predictive value and misclassification of diagnosis of pulmonary embolism and deep vein thrombosis in Swedish patient registries

Cited by 42 publications

References 15 publications

Validation of the Swedevox registry of continuous positive airway pressure, long-term mechanical ventilator and long-term oxygen therapy

Validation of the Swedevox registry of continuous positive airway pressure, long-term mechanical ventilator and long-term oxygen therapy

Alcohol Consumption and Risk of First-Time Venous Thromboembolism in Men and Women

Physical activity and risk of first-time venous thromboembolism

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