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Misclassification of hypertrophic cardiomyopathy: validation of diagnostic codes
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Dept Med, Cardiol Res Unit, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Dept Med, Stockholm, Sweden..
Umea Univ, Heart Ctr, Umea, Sweden.;Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
2017 (English)In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 9, p. 403-410Article in journal (Refereed) Published
Abstract [en]

Purpose: To validate diagnostic codes for hypertrophic cardiomyopathy (HCM), analyze misclassfications, and estimate the prevalence of HCM in an unselected Swedish regional cohort. Patients and methods: Using the hospitals' electronic medical records (used for the Swedish National Patient Register), we identified 136 patients from 2006 to 2016 with the HCM-related codes 142.1 and 142.2 (International Classification of Diseases). Results: Of a total of 129 residents in the catchment area, 88 patients were correctly classified as HCM (positive predictive value 68.2%) and 41 patients (31.8%) were misclassified as HCM. Among the 88 HCM patients (52.2% males), 74 were alive and 14 were dead (15.9%). This yields an HCM prevalence of 74/ 183,337, that is, 4.0 diagnosed cases per 10,000 in the adult population aged =18 years. The underlying diagnoses of misclassified cases were mainly hypertension (31.7%) and aortic stenosis (22.0%). Other types of cardiomyopathies accounted for several cases of misclassification: dilated (nonischemic or ischemic), left ventricular noncompaction, and Takotsubo. Miscellaneous diagnoses were amyloidosis, pulmonary stenosis combined with ventricular septal defect, aortic insufficiency, athelete's heart, and atrioventricular conduction abnormality. The mean age was not significantly different between HCM and misclassified patients (65.8 +/- 15.8 vs 70.1 +/- 13.4 years; P=0.177). There were 47.8% females among HCM and 60.8% females among misclassified (P=0.118). Conclusion: One-third of patients diagnosed as HCM are misclassified, so registry data should be interpreted with caution. A correct diagnosis is important for decision-making and implementation of optimal HCM care; efforts should be made to increase awareness of HCM and diagnostic competence throughout the health care system.

Place, publisher, year, edition, pages
2017. Vol. 9, p. 403-410
Keyword [en]
diagnostic error, diagnosis, epidemiology, hypertrophic cardiomyopathy, International Classification of Diseases, register
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-333620DOI: 10.2147/CLEP.S139300ISI: 000407833900001PubMedID: 28848363OAI: oai:DiVA.org:uu-333620DiVA, id: diva2:1157695
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2017-11-29Bibliographically approved

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