title: Validation of acute myocardial infarction cases in the national health insurance research database in taiwan.
abstract: BACKGROUND
  The aim of this study was to determine the validity of acute myocardial infarction (AMI) diagnosis coding in the National Health Insurance Research Database (NHIRD) by cross-comparisons of discharge diagnoses listed in the NHIRD with those in the medical records obtained from a medical center in Taiwan.
  
  
  METHODS
  This was a cross-sectional study comparing records in the NHIRD and discharge notes in one medical center (DNMC) in the year 2008. Positive predictive values (PPVs) for AMI diagnoses were evaluated by reviewing the relevant clinical and laboratory data recorded in the discharge notes of the medical center. Agreement in comorbidities, cardiac procedures, and antiplatelet agent (aspirin or clopidogrel) prescriptions between the two databases was evaluated.
  
  
  RESULTS
  We matched 341 cases of AMI hospitalizations from the two databases, and 338 cases underwent complete chart review. Of these 338 AMI cases, 297 were confirmed with clinical and lab data, which yielded a PPV of 0.88. The consistency rate for coronary intervention, stenting, and antiplatelet prescription at admission was high, yielding a PPV over 0.90. The percentage of consistency in comorbidity diagnoses was 95.9% (324/338) among matched AMI cases.
  
  
  CONCLUSIONS
  The NHIRD appears to be a valid resource for population research in cardiovascular diseases.
authors.affiliation: Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University.
authors.forename: Ching-Lan
authors.initials: CL
authors.lastname: Cheng
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Lee
authors.forename: Po-Sheng
authors.initials: PS
authors.lastname: Chen
authors.forename: Yi-Heng
authors.initials: YH
authors.lastname: Li
authors.forename: Swu-Jane
authors.initials: SJ
authors.lastname: Lin
authors.forename: Yea-Huei Kao
authors.initials: YH
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D059019:Clinical Coding / Q000592:standards*; D000077144:Clopidogrel; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D009313:National Health Programs; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015203:Reproducibility of Results; D013624:Taiwan / Q000453:epidemiology; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin