title: Identifying Patients With Atrial Fibrillation in Administrative Data.
abstract: Identifying patients with atrial fibrillation (AF) using administrative data is important for epidemiologic and outcomes research. Although administrative data cover large populations, it is necessary to assess their validity in identifying AF patients.
  
  
  
  We used Ontario family physician electronic medical records from the Electronic Medical Record Administrative data Linked Database (EMRALD) as a reference standard to assess the accuracy of administrative data algorithms in identifying patients with AF. From a random sample of 7500 adult patients, patients with AF as recorded in family physician records were identified.
  
  
  
  The optimal algorithm consisted of any of: hospitalization or an emergency room code for AF or prescription for an AF-specific antiarrhythmic agent or billing code for cardioversion, or prescription for an anticoagulant that was accompanied by a physician billing code. for arrhythmia. The algorithm sensitivity was 80.7% (95% confidence interval [CI], 75.1-86.3), specificity 99.1% (95% CI, 98.9-99.3), positive predictive value 71.1% (95% CI, 65.1-77.1), and negative predictive value 99.5% (95% CI, 99.3-99.7). This algorithm, applied to the Ontario population, resulted in a calculated increase in AF prevalence from 1.68% to 2.36% over the years 2000-2014. Anticoagulation rates for AF patients increased from 53% in 2011 to 60% in 2014. Among AF patients receiving anticoagulants, novel oral anticoagulant utilization increased from < 5% in 2011 to > 50% in 2014.
  
  
  
  Identifying patients with AF can be done using administrative data, and the algorithm can be used to assess trends in disease burden over time and patterns of care in large populations.
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Department of Family and Community Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; University Health Network-Toronto Western Hospital Family Health Team, Toronto, Ontario, Canada. Electronic address: karen.tu@ices.on.ca.
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Robby
authors.initials: R
authors.lastname: Nieuwlaat
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: Stephanie Y
authors.initials: SY
authors.lastname: Cheng
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Wing
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Department of Family and Community Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Noah
authors.initials: N
authors.lastname: Ivers
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Clare L
authors.initials: CL
authors.lastname: Atzema
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada.
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Healey
authors.affiliation: Division of Cardiology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
mesh_terms: D000368:Aged; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000628:therapy; D000068598:Data Accuracy; D016208:Databases, Factual; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010346:Patient Care Management / Q000458:organization & administration*; D015995:Prevalence
chemical_list: D000925:Anticoagulants