Journal article
Use of Medicare data to identify coronary heart disease outcomes in the Women's Health Initiative
Circulation Cardiovascular quality and outcomes, Vol.7(1), pp.157-162
01/2014
DOI: 10.1161/CIRCOUTCOMES.113.000373
PMCID: PMC4548886
PMID: 24399330
Abstract
Data collected as part of routine clinical practice could be used to detect cardiovascular outcomes in pragmatic clinical trials or clinical registry studies. The reliability of claims data for documenting outcomes is unknown.
We linked records of Women's Health Initiative (WHI) participants aged ≥65 years to Medicare claims data and compared hospitalizations that had diagnosis codes for acute myocardial infarction or coronary revascularization with WHI outcomes adjudicated by study physicians. We then compared the hazard ratios for active versus placebo hormone therapy based solely on WHI-adjudicated events with corresponding hazard ratios based solely on claims data for the same hormone trial participants. Agreement between WHI-adjudicated outcomes and Medicare claims was good for the diagnosis of myocardial infarction (κ, 0.71-0.74) and excellent for coronary revascularization (κ, 0.88-0.91). The hormone:placebo hazard ratio for clinical myocardial infarction was 1.31 (95% confidence interval, 1.03-1.67) based on WHI outcomes and 1.29 (95% confidence interval, 1.00-1.68) based on Medicare data. The hazard ratio for coronary revascularization was 1.09 (95% confidence interval, 0.88-1.35) based on WHI outcomes and 1.10 (95% confidence interval, 0.89-1.35) based on Medicare data. The differences between hazard ratios derived from WHI and Medicare data were not significant in 1000 bootstrap replications.
Medicare claims may provide useful data on coronary heart disease outcomes among patients aged ≥65 years in clinical research studies.
URL: www.clinicaltrials.gov. Unique identifier: NCT00000611.
Details
- Title: Subtitle
- Use of Medicare data to identify coronary heart disease outcomes in the Women's Health Initiative
- Creators
- Mark A Hlatky - Stanford University School of Medicine, Stanford, CARoberta M RayDale R BurwenKaren L MargolisKaren C JohnsonAnna Kucharska-NewtonJoAnn E MansonJennifer G RobinsonMonika M SaffordMatthew AllisonThemistocles L AssimesAnthony A BavryJeffrey BergerRhonda M Cooper-DeHoffSusan R HeckbertWenjun LiSimin LiuLisa W MartinMarco V PerezHilary A TindleWolfgang C WinkelmayerMarcia L Stefanick
- Resource Type
- Journal article
- Publication Details
- Circulation Cardiovascular quality and outcomes, Vol.7(1), pp.157-162
- Publisher
- United States
- DOI
- 10.1161/CIRCOUTCOMES.113.000373
- PMID
- 24399330
- PMCID
- PMC4548886
- ISSN
- 1941-7705
- eISSN
- 1941-7705
- Grant note
- P20 MD006899 / NIMHD NIH HHS HHSN268201100002I / NHLBI NIH HHS HHSN271201100004C / NIA NIH HHS HHSN268201100046C / PHS HHS HHSN268201100001C / WHI NIH HHS HHSN268201100004I / NHLBI NIH HHS HHSN271201100004C / PHS HHS HHSN268201100003C / PHS HHS HHSN268201100004C / WHI NIH HHS HHSN268201100046C / NHLBI NIH HHS HHSN268201100002C / WHI NIH HHS HHSN268201100001I / NHLBI NIH HHS HHSN268201100004C / PHS HHS N01 WH042109 / WHI NIH HHS HHSN268201100002C / PHS HHS HHSN268201100003C / WHI NIH HHS HHSN268201100001C / PHS HHS
- Language
- English
- Date published
- 01/2014
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983996099802771
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