Congestive Heart Failure Incidence and Prognosis: Case Identification Using Central Adjudication Versus Hospital Discharge Diagnoses
Department of Epidemiology, University of Washington, Seattle, WA 98101, and Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN, USA. Annals of Epidemiology
(Impact Factor: 2).
03/2006; 16(2):115-22. DOI: 10.1016/j.annepidem.2005.02.012
We compared hospitalized congestive heart failure (CHF) incidence and prognosis estimates using hospital discharge diagnoses or central adjudication.
We used the Cardiovascular Health Study (CHS), a population-based cohort study of 5888 elderly adults. A physician committee adjudicated potential CHF events, confirmed by signs, symptoms, clinical tests, and/or medical therapy. A CHF discharge diagnosis included any of these ICD-9 codes in any position: 428, 425, 398.91, 402.01, 402.11, 402.91, and 997.1. We constructed an inception cohort of 1209 hospitalized, nonfatal, incident CHF cases, identified by discharge diagnosis, adjudication, or both.
Incidence rates for hospitalized CHF were 24.6 per 1000 person-years using discharge diagnoses and 17.1 per 1000 person-years using central adjudication. Compared to the group identified as having CHF by both methods, the group with only a discharge diagnosis (hazard ratio=0.77, 95% confidence interval=0.65-0.91) and the group with central adjudication only (hazard ratio=0.72, 95% confidence interval=0.55-0.94) had lower mortality rates.
In the elderly, studies using only discharge diagnoses, as compared to central adjudication, may estimate higher rates of incident hospitalized CHF. Mortality following CHF onset may be similar for these methods and higher if both methods are used together.
Available from: Claudia Blais
- "786.0 Heckbert (40), 2004 USA 1994–2000 34,016 ICD-9: 425, 428 Fisher (11), 1992 USA 1984–1985 7050 ICD-9-CM: 402.01, 402.11, 402.91, 428–428.9 Schellenbaum (24), 2006 USA 1989–1993 1209 ICD-9: 428, 997.1, 425, 402.01, 402.11, 402.91, 398.91 ICD-9: 428, 398.91, 402.01, 402.11, 402.91, 404.00, 404.01 REACH study: 404.03, 404.10, 404.11, 404.13, 404.90, 404.91, 404.93 Fowles (9), 1998 USA 1990–1991 1596 Not reported Kashner (13), 1998 USA 1995 414 ICD-9: 428, 428.0, 428.1, 428.9 Inglesson (27), 2005 Sweden 1976–2001 321 ICD-8: 427.00, 427.10, 428.99 ICD-9: 428 ICD-10: I50, I11.0 Fonseca (26), 2008 Portugal 2001 234 ICD-9: 428, 410–414, 402, 404, 415, 416, 427, 420, 421, 422, 423, 424, 425, 391, 393–398, 745–746 Teng (25), 2008 Australia 1996–2006 1006 ICD-9: 428x, 402.01, 402.11, 402.91, 404.1, 404.3, 425x, 518.4, 514, 391.8, 398.91 ICD-10: I50x, I11.0, I13.0, I13.2, I42x, J81, I01.8, I020 Kumler (29), 2008 Denmark 1998–1999 126 ICD-10: DI50.0–DI50.9 "
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ABSTRACT: Many studies have relied on administrative data to identify patients with heart failure (HF).
To systematically review studies that assessed the validity of administrative data for recording HF.
English peer-reviewed articles (1990 to 2008) validating International Classification of Diseases (ICD)-8, -9 and -10 codes from administrative data were included. An expert panel determined which ICD codes should be included to define HF. Frequencies of ICD codes for HF were calculated using up to the 16 diagnostic coding fields available in the Canadian hospital discharge abstract during fiscal years 2000⁄2001 and 2005⁄2006.
Between 1992 and 2008, more than 70 different ICD codes for defining HF were used in 25 published studies. Twenty-one studies validated hospital discharge abstract data; three studies validated physician claims and two studies validated ambulatory care data. Eighteen studies reported sensitivity (range 29% to 89%). Specificity and negative predictive value were greater than 70% across 17 studies. Nineteen studies reported positive predictive values (range 12% to 100%). Ten studies reported kappa values (range 0.39 to 0.84). For Canadian hospital discharge data, ICD-9 and -10 codes 428 and I50 identified HF in 5.50% and 4.80% of discharge records, respectively. Additional HF-related ICD-9 and -10 codes did not impact HF prevalence.
The ICD-9 and -10 codes 428 and I50 were the most commonly used to define HF in hospital discharge data. Validity of administrative data in recording HF varied across the studies and data sources that were assessed.
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ABSTRACT: Millimeter wave downconverters intended for systems applications have been developed using thin film planar technology. The downconverters, operating with subharmonic-pumping, have achieved a total receiver noise figure as low as 5.7 dB SSB over an RF Bandwidth in excess of 20%. The converters are fixed-tuned, requiring no adjustments, and utilize improved planar Schottky barrier diodes which exhibit up to 3.5 THz zero bias cutoff frequencies. Although subharmonically pumped, the downconverters exhibit performance which in many respects is superior to conventional balanced mixers, and may provide a useful solution to cost effective systems requirements at millimeter wavelengths.
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ABSTRACT: Long baseline (LBL) acoustic navigation techniques have
traditionally been used to find the position of vehicles or towed
systems in the deep ocean. LBL techniques compute the vehicle position
by triangulation, based on measured acoustic ranges to fixed acoustic
transponders. There is a considerable motivation to develop an accurate
relative navigation system, whereby the subsea vehicle position may be
calculated with respect to the surface ship, based on a range and
bearing measurement, thus eliminating the need for bottom transponders.
The vehicle's position may then be found in world coordinates, by adding
the relative position of the vehicle to the GPS position found for the
ship. The errors associated with relative navigation are primarily
angular in nature, thus making it difficult to achieve sufficient
accuracy at long ranges to satisfy the survey requirements. This paper
describes RATS (Relative Acoustic Tracking System), which was developed
by the Woods Hole Oceanographic Institution specifically for determining
the position of the TOSS deep towed imaging vehicle system, operated by
the Naval Oceanographic Office. RATS utilizes wide band signaling
techniques with DSP (digital signal processor) implementation, combined
with six axis motion compensation to obtain high accuracy relative
positioning of the towed system with respect to the surface ship. A
complete description of the system, as well as field results from deep
ocean operations, is presented
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