Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review.
Background: Major adverse cardiovascular events (MACE) are increasingly used as composite outcomes in randomized controlled trials (RCTs) and observational studies. However, it is unclear how observational studies most commonly define MACE in the literature when using administrative data.Methods: We...
| Publicado en: | BMC Medical Research Methodology Vol. 21; no. 1; pp. 1 - 19 |
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| Autores principales: | , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
BioMed Central
11/6/2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=153435621&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153435621 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712288 1CI1 jtl: BMC Medical Research Methodology issn: 14712288 maglogo: N pubinfo: dt: 11/6/2021 vid: 21 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 153435621 153435621 NLM34742250 153435621 10.1186/s12874-021-01440-5 NLM34742250 153435621 ppf: 1 ppct: 18 formats: tig: atl: Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review. aug: au: Bosco, Elliott Hsueh, Leon McConeghy, Kevin W. Gravenstein, Stefan Saade, Elie affil: Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, 02912, Providence, RI, USA sug: subj: Myocardial Infarction Epidemiology Stroke Diagnosis Heart Failure Stroke Epidemiology Cardiovascular Diseases Epidemiology Myocardial Infarction Diagnosis Cardiovascular Diseases Diagnosis Human Systematic Review ab: Background: Major adverse cardiovascular events (MACE) are increasingly used as composite outcomes in randomized controlled trials (RCTs) and observational studies. However, it is unclear how observational studies most commonly define MACE in the literature when using administrative data.Methods: We identified peer-reviewed articles published in MEDLINE and EMBASE between January 1, 2010 to October 9, 2020. Studies utilizing administrative data to assess the MACE composite outcome using International Classification of Diseases 9th or 10th Revision diagnosis codes were included. Reviews, abstracts, and studies not providing outcome code definitions were excluded. Data extracted included data source, timeframe, MACE components, code definitions, code positions, and outcome validation.Results: A total of 920 articles were screened, 412 were retained for full-text review, and 58 were included. Only 8.6% (n = 5/58) matched the traditional three-point MACE RCT definition of acute myocardial infarction (AMI), stroke, or cardiovascular death. None matched four-point (+unstable angina) or five-point MACE (+unstable angina and heart failure). The most common MACE components were: AMI and stroke, 15.5% (n = 9/58); AMI, stroke, and all-cause death, 13.8% (n = 8/58); and AMI, stroke and cardiovascular death 8.6% (n = 5/58). Further, 67% (n = 39/58) did not validate outcomes or cite validation studies. Additionally, 70.7% (n = 41/58) did not report code positions of endpoints, 20.7% (n = 12/58) used the primary position, and 8.6% (n = 5/58) used any position.Conclusions: Components of MACE endpoints and diagnostic codes used varied widely across observational studies. Variability in the MACE definitions used and information reported across observational studies prohibit the comparison, replication, and aggregation of findings. Studies should transparently report the administrative codes used and code positions, as well as utilize validated outcome definitions when possible. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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