Institute for Health Promotion, Cardiovascular Genome Center, Yonsei University, Seoul, Korea.
Korean Circ J. 2012 Jan;42(1):10-5. doi: 10.4070/kcj.2012.42.1.10. Epub 2012 Jan 31.
Medical insurance claims (MIC) data are one of the largest sources of outcome data in the form of International Classification of Diseases (ICD) codes. We evaluated the validity of the ICD codes from the Korean National MIC data with respect to the outcomes from acute myocardial infarction (AMI) in the Korean Heart Study.
Baseline information was obtained from health examinations conducted from 1994 to 2001. Outcome information regarding the incidence of AMI came from hospital admission discharge records from 1994 to 2007. Structured questionnaires were sent to 98 hospitals. In total, 107 cases of AMI with ICD codes of I21- (93 men, 26-73 years of age) were included in the final analyses. ICD code accuracy and reliability (kappa) for AMI were calculated.
A large number of AMI cases were from hospitals located in the Seoul area (75.9%). The accuracy of AMI was 71.4%, according to World Health Organization criteria (1997-2000, n=24, kappa=0.46) and 73.1% according to the European Society of Cardiology/American College of Cardiology (ESC/ACC) criteria (2001-2007, n=83, kappa=0.74). An age of 50 years or older was the only factor related to inaccuracy of codes for AMI (odds ratio, 4.6; 95% confidence interval, 1.2-17.7) in patients diagnosed since January 2001 using ESC/ACC criteria (n=83).
The accuracy for diagnosing AMI using the ICD-10 codes in Korean MIC data was >70%, and reliability was fair to good; however, more attention is required for recoding ICD codes in older patients.
医疗保险索赔（MIC）数据是国际疾病分类（ICD）代码形式的最大规模结局数据来源之一。我们评估了韩国国家 MIC 数据中 ICD 代码与韩国心脏研究中急性心肌梗死（AMI）结局的相关性。
基线信息来自于 1994 年至 2001 年进行的健康检查。关于 AMI 发病的结局信息来自于 1994 年至 2007 年的住院出院记录。向 98 家医院发放了结构化问卷。共纳入 107 例经 ICD 编码为 I21-（93 例男性，年龄 26-73 岁）的 AMI 病例进行最终分析。计算了 AMI 的 ICD 编码准确性和可靠性（kappa）。
大量 AMI 病例来自于首尔地区的医院（75.9%）。根据世界卫生组织标准（1997-2000 年，n=24，kappa=0.46），AMI 的准确性为 71.4%，根据欧洲心脏病学会/美国心脏病学会标准（ESC/ACC，2001-2007 年，n=83，kappa=0.74）为 73.1%。2001 年 1 月以后使用 ESC/ACC 标准（n=83）诊断的患者中，年龄 50 岁或以上是 AMI 编码不准确的唯一相关因素（比值比，4.6；95%置信区间，1.2-17.7）。
在韩国 MIC 数据中，使用 ICD-10 编码诊断 AMI 的准确性>70%，可靠性为良到优；然而，对于老年患者的 ICD 编码，需要更加注意重新编码。
