Nakai Michikazu, Iwanaga Yoshitaka, Sumita Yoko, Kanaoka Koshiro, Kawakami Rika, Ishii Masanobu, Uchida Keiji, Nagano Nobutaka, Nakayama Takeo, Nishimura Kunihiro, Tsuchihashi Kazufumi, Kimura Kazuo, Saito Yoshihiro, Tsujita Kenichi, Ogawa Hisao, Miyamoto Yoshihiro, Yasuda Satoshi
National Cerebral and Cardiovascular Center Suita Japan.
Department of Cardiovascular Medicine, Nara Medical University Kashihara Japan.
Circ Rep. 2021 Feb 20;3(3):131-136. doi: 10.1253/circrep.CR-21-0004.
Big data systems such as diagnosis procedure combination (DPC) datasets have recently been used for research purposes. However, there have been few validation studies to determine the accuracy of diagnoses. The aim of this study was to validate and evaluate 2 diagnoses, namely acute myocardial infarction (AMI) and heart failure (HF), using International Classification of Diseases, 10th revision (ICD-10) codes in the Japanese Registry Of All cardiac and vascular Disease (JROAD)-DPC database. ICD-10 codes I21.0-I21.9 and I50.0-I50.9 were used to identify AMI and HF, respectively, in the JROAD-DPC database. Diagnoses of AMI and HF were validated in clinical datasets assessing sensitivity and positive predictive value (PPV). Over 1-2 years, 742 patients hospitalized for AMI and 1,368 patients hospitalized for HF were identified in the DPC dataset. Sensitivity and PPV for AMI were 78.9% and 78.8%, respectively. When emergency hospitalization was included as a criterion, PPV increased to 84.9%. For HF, sensitivity and PPV were 84.7% and 57.0%, respectively. When emergency hospitalization and acute HF were included as criteria, PPV increased to 83.0%. Using ICD-10 codes for AMI and HF diagnoses among hospitalized patients, the DPC dataset showed acceptable concordance with clinical datasets. PPV increased when any conditions of hospitalization were included, especially in HF.
诸如诊断程序组合（DPC）数据集之类的大数据系统最近已被用于研究目的。然而，很少有验证研究来确定诊断的准确性。本研究的目的是在日本所有心脏和血管疾病登记处（JROAD）-DPC数据库中，使用国际疾病分类第10版（ICD-10）编码对急性心肌梗死（AMI）和心力衰竭（HF）这两种诊断进行验证和评估。在JROAD-DPC数据库中，分别使用ICD-10编码I21.0-I21.9和I50.0-I50.9来识别AMI和HF。在评估敏感性和阳性预测值（PPV）的临床数据集中对AMI和HF的诊断进行了验证。在1至2年的时间里，DPC数据集中识别出742例因AMI住院患者和1368例因HF住院患者。AMI的敏感性和PPV分别为78.9%和78.8%。当将急诊住院作为一项标准纳入时，PPV提高到84.9%。对于HF，敏感性和PPV分别为84.7%和57.0%。当将急诊住院和急性HF作为标准纳入时，PPV提高到83.0%。在住院患者中使用ICD-10编码诊断AMI和HF时，DPC数据集与临床数据集显示出可接受的一致性。当纳入任何住院条件时PPV会提高，尤其是在HF方面。
