Accuracy of a heart failure diagnosis in administrative registers.
BACKGROUND
The incidence of heart failure is frequently reported using hospital discharge diagnoses. The specificity of a diagnosis has been shown to be high but the sensitivity of a reported diagnosis is unknown.


OBJECTIVE
To study the accuracy of a heart failure diagnosis reported to the Danish National Patient Registers during routine clinical work.


METHODS
The patient population consisted of 3644 consecutive patients admitted to all departments in one hospital. Diagnoses reported to the National Patient Register were recorded. A study team evaluated each patient independently of routine care, performed an echocardiogram and evaluated whether clinical symptoms of heart failure were present. Heart failure was defined in accordance with current ESC guidelines as symptoms of heart failure and evidence of cardiac dysfunction.


RESULTS
A registered diagnosis of heart failure (n=126) carried a specificity of 99% and a sensitivity of 29% for all patients. The positive predictive value was 81%, the negative predictive value 90%.


CONCLUSIONS
The diagnosis of Heart Failure in the Danish National Registers is underreported, but very specific.
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark. tkumler@dadlnet.dk
Thomas
T
Kümler
Gunnar Hilmar
GH
Gislason
Vibeke
V
Kirk
Morten
M
Bay
Olav W
OW
Nielsen
Lars
L
Køber
Christian
C
Torp-Pedersen
D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D012042:Registries; D012680:Sensitivity and Specificity