title: Validation of acute myocardial infarction in the Food and Drug Administration's Mini-Sentinel program.
abstract: OBJECTIVE
  To validate an algorithm based upon International Classification of Diseases, 9(th) revision, Clinical Modification (ICD-9-CM) codes for acute myocardial infarction (AMI) documented within the Mini-Sentinel Distributed Database (MSDD).
  
  
  METHODS
  Using an ICD-9-CM-based algorithm (hospitalized patients with 410.x0 or 410.x1 in primary position), we identified a random sample of potential cases of AMI in 2009 from four Data Partners participating in the Mini-Sentinel Program. Cardiologist reviewers used information abstracted from hospital records to assess the likelihood of an AMI diagnosis based on criteria from the Joint European Society of Cardiology and American College of Cardiology Global Task Force. Positive predictive values (PPVs) of the ICD-9-based algorithm were calculated.
  
  
  RESULTS
  Of the 153 potential cases of AMI identified, hospital records for 143 (93%) were retrieved and abstracted. Overall, the PPV was 86.0% (95% confidence interval; 79.2%, 91.2%). PPVs ranged from 76.3% to 94.3% across the four Data Partners.
  
  
  CONCLUSIONS
  The overall PPV of potential AMI cases, as identified using an ICD-9-CM-based algorithm, may be acceptable for safety surveillance; however, PPVs do vary across Data Partners. This validation effort provides a contemporary estimate of the reliability of this algorithm for use in future surveillance efforts conducted using the Food and Drug Administration's MSDD.
authors: Meyers Primary Care Institute-Fallon Community Health Plan, Reliant Medical Group, and University of Massachusetts Medical School, Worcester, MA, USA. Sarah.cutrona@umassmemorial.org
authors: Sarah L
authors: SL
authors: Cutrona
authors: Sengwee
authors: S
authors: Toh
authors: Aarthi
authors: A
authors: Iyer
authors: Sarah
authors: S
authors: Foy
authors: Gregory W
authors: GW
authors: Daniel
authors: Vinit P
authors: VP
authors: Nair
authors: Daniel
authors: D
authors: Ng
authors: Melissa G
authors: MG
authors: Butler
authors: Denise
authors: D
authors: Boudreau
authors: Susan
authors: S
authors: Forrow
authors: Robert
authors: R
authors: Goldberg
authors: Joel
authors: J
authors: Gore
authors: David
authors: D
authors: McManus
authors: Judith A
authors: JA
authors: Racoosin
authors: Jerry H
authors: JH
authors: Gurwitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014481:United States; D014486:United States Food and Drug Administration