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. 2010 Jun;19(6):563-72.
doi: 10.1002/pds.1888.

A computer case definition for sudden cardiac death

Cecilia P Chung  1 , Katherine T Murray, C Michael Stein, Kathi Hall, Wayne A Ray
Affiliations

A computer case definition for sudden cardiac death

Cecilia P Chung et al. Pharmacoepidemiol Drug Saf. 2010 Jun.

Abstract

Purpose: To facilitate studies of medications and sudden cardiac death, we developed and validated a computer case definition for these deaths. The study of community dwelling Tennessee Medicaid enrollees 30-74 years of age utilized a linked database with Medicaid inpatient/outpatient files, state death certificate files, and a state 'all-payers' hospital discharge file.

Methods: The computerized case definition was developed from a retrospective cohort study of sudden cardiac deaths occurring between 1990 and 1993. Medical records for 926 potential cases had been adjudicated for this study to determine if they met the clinical definition for sudden cardiac death occurring in the community and were likely to be due to ventricular tachyarrhythmias. The computerized case definition included deaths with (1) no evidence of a terminal hospital admission/nursing home stay in any of the data sources; (2) an underlying cause of death code consistent with sudden cardiac death; and (3) no terminal procedures inconsistent with unresuscitated cardiac arrest. This definition was validated in an independent sample of 174 adjudicated deaths occurring between 1994 and 2005.

Results: The positive predictive value of the computer case definition was 86.0% in the development sample and 86.8% in the validation sample. The positive predictive value did not vary materially for deaths coded according to the ICO-9 (1994-1998, positive predictive value = 85.1%) or ICD-10 (1999-2005, 87.4%) systems.

Conclusion: A computerized Medicaid database, linked with death certificate files and a state hospital discharge database, can be used for a computer case definition of sudden cardiac death.

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Figures

Figure 1
Figure 1
Identification of potential sudden cardiac deaths that were subsequently adjudicated by medical record review and used both to develop and validate a computer case definition for sudden cardiac death. This includes both the development study, the deaths from which were used to construct the computer case definition, and the validation study, the deaths from which were used to validate the definition derived from the development study
Figure 2
Figure 2
Computer case definition for sudden cardiac death.
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