Positive predictive value of the diagnosis of acute myocardial infarction in an administrative database

OBJECTIVE:To determine the positive predictive value of ICD-9-CM coding of acute myocardial infarction and cardiac procedures. METHODS: Using chart-abstracted data as the standard, we examined administr ative data from the Veterans Health Administration for a national random sa mple of 5,151 discharges. MAIN RESULTS: The positive predictive value of acute myocardial infarction coding in the primary position was 96.9%. The sensitivity and specificity o f coding were, respectively, 96% and 99% for catheterization, 95.7% and 100 % for coronary artery bypass graft surgery, and 90.3% and 99.7% for percuta neous transruminal coronary angioplasty. CONCLUSIONS: The positive predictive value of acute myocardial infarction a nd related procedure coding is comparable to or better than previously repo rted observations of administrative databases.