Martin C A, Hobbs M S, Armstrong B K
Department of Medicine, University of Western Australia, M Block, Queen Elizabeth II Medical Centre, Nedlands.
J Chronic Dis. 1987;40(12):1111-20. doi: 10.1016/0021-9681(87)90078-6.
The validity of identifying incident cases of non-fatal acute myocardial infarction (AMI) between 1971 and 1982 in Western Australia from routine hospital records was assessed in ages 25-64 years, according to the WHO criteria defined in 1970 and 1983. This was done by reviewing original data sources and by using the Perth Coronary Register of 1971 as an external reference. Events with a coded discharge diagnosis of acute or subacute ischemic heart disease were found to be highly sensitive (97%) for cases of "definite" AMI (WHO 1983 criteria). The specificity of such events was lower (positive predictive value of about 70%) and validation of these events would be necessary for studies requiring high specificity. The sensitivity and specificity of these events for "definite" AMI seemed quite stable over time with similar values being observed in 1971 and 1978. Although the situation for "possible" AMI (non-fatal) is less clear, certainly many more records would need to be reviewed to validate this diagnosis.
根据1970年和1983年世界卫生组织（WHO）的标准，对1971年至1982年西澳大利亚州25至64岁人群中，通过常规医院记录识别非致命性急性心肌梗死（AMI）发病病例的有效性进行了评估。通过查阅原始数据源，并以1971年的珀斯冠心病登记册作为外部参考来完成此项评估。对于“确诊”的AMI病例（WHO 1983年标准），编码出院诊断为急性或亚急性缺血性心脏病的事件被发现具有很高的敏感性（97%）。此类事件的特异性较低（阳性预测值约为70%），对于需要高特异性的研究而言，有必要对这些事件进行验证。随着时间推移，这些事件对于“确诊”AMI的敏感性和特异性似乎相当稳定，1971年和1978年观察到了相似的值。尽管“可能”的AMI（非致命性）情况尚不清楚，但肯定需要查阅更多记录来验证这一诊断。
