Validity of coronary heart diseases and heart failure based on hospital discharge and mortality data in the Netherlands using the cardiovascular registry Maastricht cohort study

Audrey H. H. Merry*, Jolanda M. A. Boer, Leo J. Schouten, Edith J. M. Feskens, W. M. Monique Verschuren, Anton P. M. Gorgels, Piet A. van den Brandt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Incidence rates of cardiovascular diseases are often estimated by linkage to hospital discharge and mortality registries. The validity depends on the quality of the registries and the linkage. Therefore, we validated incidence rates of coronary heart disease (CHD), acute myocardial infarction, unstable angina pectoris, and heart failure, estimated by this method, against the disease registry of the cardiovascular registry Maastricht cohort study. The cohort consists of 21,148 persons, born between 1927 and 1977, who were randomly sampled from Maastricht and surrounding communities in 1987-1997. Incident cases were identified by linkage to the Netherlands causes of death registry and either the hospital discharge registry (HDR) or the cardiology information system (CIS) of the University Hospital Maastricht. Sensitivities and positive predictive values were calculated using the CIS-based registry as gold standard. Relatively high sensitivities and positive predictive values were found for CHD (72 and 91%, respectively) and acute myocardial infarction (84 and 97%, respectively). These values were considerably lower for unstable angina pectoris (53 and 78%, respectively) and heart failure (43 and 80%, respectively). A substantial number of cases (14-47%) were found only in the CIS-based registry, because they were missed or miscoded in the HDR-based registry. As a consequence, the incidence rates in the HDR-based registry were considerably lower than in the CIS-based registry, especially for unstable angina pectoris and heart failure. Incidence rates based on hospital discharge and mortality data may underestimate the true incidence rates, especially for unstable angina pectoris and heart failure.
Original languageEnglish
Pages (from-to)237-247
Number of pages11
JournalEuropean Journal of Epidemiology
Volume24
Issue number5
DOIs
Publication statusPublished - May 2009

Keywords

  • Coronary Heart Disease
  • Heart Failure
  • Hospital discharge diagnoses
  • Mortality
  • Sudden Cardiac Arrest
  • Validity

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