Coronary heart disease surveillance: field application of an epidemiologicalgorithm

This report describes the performance of a surveillance system and computer ized algorithm for the assignment of definite or probable hospitalized card iac events for large epidemiologic studies. The algorithm, developed by the Coordinating Committee for Community Demonstration Studies (CCCDS), evolve d from the Gillum criteria, and included selected ICD-9-CM codes including codes 410 through 414 for discharge record screening, plus creatine kinase. For the small percentage of cases in which enzyme analysis was inconclusiv e (8%), presence of pain and/or Minnesota-coded electrocardiograms were inc luded to define the outcome. All data items were easily obtained from medic al records by trained lay record abstractors and required no interpretation . From January 1980 through December 1991, 21,183 medical records were scre ened for ICD-9-CM codes 410 through 414. Of all 410 to 411 ICD-9-CM codes ( n = 9026), 36.9% (n = 3220) were classified as definite cardiac events and 10.6% (n = 1057) as probable events. Of all 412 through 414 codes (n = 9070 ), only 1.8% (n = 227) were classified as definite cardiac events and 5.4% (n = 716) as probable events. The epidemiologic diagnostic algorithm presen ted in this article used computerized data to assign diagnoses in a standar d, objective manner, and was a lower cost alternative to classification of cardiac events on the basis of clinical review and/or more complex record a bstraction approaches. (C) 2000 Elsevier Science Inc. All rights reserved.