Author Interviews, Electronic Records, Emergency Care, Heart Disease, JACC / 07.05.2015

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. (more…)
Author Interviews, BMJ, Mental Health Research / 12.06.2014

MedicalResearch.com Interview with: Emma Maund, PhD student Nordic Cochrane Centre Copenhagen, Denmark

MedicalResearch: What are the main findings of the study:

Answer: For statisticians to analyse adverse events recorded in a clinical trial, it is necessary that events described by the original investigators are coded to terms in a specialised medical coding dictionary. Our study assessed the effects of coding and coding conventions on summaries and tabulations of adverse events data on suicidality within clinical study reports of nine randomised controlled trials of duloxetine for the treatment of major depressive disorder. Trials used either the medical coding dictionary COSTART (Coding Symbols for a Thesaurus of Adverse Reaction Terms) or the larger and more recent dictionary MedDRA (Medical Dictionary for Regulatory Activities). We found suicides were clearly identifiable in all formats of adverse event data. Suicide attempts in tables included both definitive and provisional diagnoses. Suicidal ideation and preparatory behaviour were obscured in some tables owing to the lack of specificity of the medical coding dictionary, especially in trials using COSTART where the closest matching term available was depression. (more…)