Emergency Room Coding Of Heart Failure Diagnosis Validated

Justin A. Ezekowitz, MBBCh MScAssociate Professor, University of Alberta Co-Director, Canadian VIGOUR Centre Director, Heart Function Clinic Cardiologist, Mazankowski Alberta Heart InstiMedicalResearch.com Interview with:
Justin A. Ezekowitz, MBBCh MSc
Associate Professor, University of Alberta
Co-Director, Canadian VIGOUR Centre
Director, Heart Function Clinic
Cardiologist, Mazankowski Alberta Heart Institute

Medical Research: What is the background for this study?

Dr. Ezekowitz: Heart Failure is a prevalent health issue that carries high morbidity and mortality. Most epidemiologic research derives information from hospital discharge abstracts, but emergency department visits are another source of information. Many have assumed this code is accurate in the emergency department but uncertainty remains.

In our study, we assessed patients at their presentation to Emergency Department, which is usually the first medical contact for acutely ill patients with heart failure.

The objective of our study was to compare administrative codes for acute heart failure (I50.x) in the emergency department against a gold standard of clinician adjudication.

Medical Research: What are the main findings?

Dr. Ezekowitz: Emergency department administrative data is highly correlated with a clinician adjudicated diagnosis. The positive predictive value of acute heart failure as the main diagnosis was 93.3% when compared to clinician adjudication, supported by standardized scoring systems and elevated BNP.

Medical Research: What should clinicians and patients take away from your report?

Dr. Ezekowitz: The code for acute heart failure in emergency department administrative data has a high Positive Predictive Value and may be used in outcomes research.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Ezekowitz: Studies using administrative codes should exercise caution when evaluating codes related to the acute disease, especially when a diagnosis may evolve, such as in the emergency department. Further validation of other disease states is required, and researchers should use validated, disease-specific scoring systems supported by biomarker or imaging where possible.

Citation:

 

 

MedicalResearch.com Interview with: Justin A. Ezekowitz, MBBCh MSc (2015). Emergency Room Coding Of Heart Failure Diagnosis Validated