Validating Acute Myocardial Infarction Diagnoses in National Health Registers for Use as Endpoint in Research: The Tromsø Study

Torunn Varmdal,1,2 Ellisiv B Mathiesen,1,3 Tom Wilsgaard,1 Inger Njølstad,1 Audhild Nyrnes,1 Sameline Grimsgaard,1 Kaare Harald Bønaa,2,4 Jan Mannsverk,1 Maja-Lisa Løchen1,5 1Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; 2Department of Circulation and Medical...

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Bibliographic Details
Main Authors: Varmdal T, Mathiesen EB, Wilsgaard T, Njølstad I, Nyrnes A, Grimsgaard S, Bønaa KH, Mannsverk J, Løchen ML
Format: Article in Journal/Newspaper
Language:English
Published: Dove Medical Press 2021
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Online Access:https://doaj.org/article/bcf705b056604529ae3669177006fb89
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Summary:Torunn Varmdal,1,2 Ellisiv B Mathiesen,1,3 Tom Wilsgaard,1 Inger Njølstad,1 Audhild Nyrnes,1 Sameline Grimsgaard,1 Kaare Harald Bønaa,2,4 Jan Mannsverk,1 Maja-Lisa Løchen1,5 1Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; 2Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; 3Department of Neurology, University Hospital of North Norway, Tromsø, Norway; 4Clinic for Heart Disease, St. Olav’s University Hospital, Trondheim, Norway; 5Department of Cardiology, University Hospital of North Norway, Tromsø, NorwayCorrespondence: Torunn VarmdalDepartment of Community Medicine, UiT The Arctic University of Norway, Postboks 6050 Langnes, Tromsø, 9037, NorwayTel +47 930 28 286Email torunn.varmdal@ntnu.noPurpose: To assess whether acute myocardial infarction (MI) diagnoses in national health registers are sufficiently correct and complete to replace manual collection of endpoint data for a population-based, epidemiological study.Patients and Methods: Using the Tromsø Study Cardiovascular Disease Register for 2013– 2014 as gold standard, we calculated correctness (defined as positive predictive value (PPV)) and completeness (defined as sensitivity) of MI cases in the Norwegian Myocardial Infarction Register and the Norwegian Patient Register separately and in combination. We calculated the sensitivity and PPV with 95% confidence intervals using the Clopper-Pearson Exact test.Results: We identified 153 MI cases in the gold standard. In the Norwegian Myocardial Infarction Register, we found a PPV of 97.1% (95% confidence interval (CI) 92.8– 99.2) and a sensitivity of 88.2% (95% CI 82.0– 92.9). In the Norwegian Patient Register, the PPV was 96.3% (95% CI 91.6– 98.8) and the sensitivity was 85.6% (95% CI 79.0– 90.8). The combined dataset of the Norwegian Myocardial Infarction Register and the Norwegian Patient Register had a PPV of 96.6% (95% CI 92.1– 98.9) and a sensitivity of 91.5% (95% CI 85.9– 95.4).Conclusion: MI diagnoses in ...