Abstract MP48: Ascertainment of Newly-Diagnosed Atrial Fibrillation Using Cohort Follow up Versus Centers for Medicare and Medicaid Services Data in the Atherosclerosis Risk in Communities Study
Background: Increasingly, administrative data are being used for epidemiologic studies to identify atrial fibrillation (AF) patients. Despite data indicating that administrative data could be a promising source for identifying AF patients, the ability to identify incident AF is not well understood. We examined the concordance of incident AF diagnosis based on Centers for Medicare and Medicaid Services (CMS) data and cohort follow up in the Atherosclerosis Risk in Communities (ARIC) study.
Methods: ARIC cohort participants enrolled in fee-for-service (FFS) Medicare, both Parts A and B, for at least 12 continuous months between January 1, 1991, and December 31, 2009, were eligible for inclusion. Individuals with diagnosed AF before January 1, 1992, were excluded. Additionally, AF diagnoses occurring simultaneously with cardiac surgery, without a subsequent AF diagnosis, were excluded. In the ARIC cohort follow up, incident cases of AF were ascertained through hospital discharge codes and death certificates (ICD-9 code 427.3x; ICD-10 code I48). Using MedPAR and outpatient CMS claims, incident AF was defined as an AF discharge diagnosis (ICD-9 code 427.3x; ICD-10 code I48), in any position, on a single inpatient or two outpatient claims within 7 [[Unable to Display Character: –]] 365 days. Secondary CMS definitions were restricted to only inpatient and only outpatient claims criteria. Concordance of events between ARIC and CMS were assessed with a kappa (κ) statistic and percent agreement.
Results: Of the 10,856 ARIC participants enrolled in FFS Medicare for at least 12 months, 778 developed AF according to both the ARIC and primary CMS definitions; an additional 87 and 634 incident cases were identified using only ARIC and CMS data, respectively. Overall agreement between the data sources was 93% and the κ statistic was 0.65 (Table). Agreement was better for inpatient CMS claims.
Conclusion: Concordance of incident inpatient AF between ARIC cohort follow up and CMS data is acceptable, though more AF cases were identified from CMS largely due to outpatient AF.
- © 2013 by American Heart Association, Inc.