American Journal of Epidemiology Vol. 151, No. 8: 790-797
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Comparison of Computer-assigned Minnesota Codes with the Visual Standard Method for New Coronary Heart Disease Events
1Department of Medical Informatics, Erasmus University Rotterdam, Netherlands
2Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis, MN
3EPICARE Center Winston-Salem, NC
Reprint reqests to Dr. Richard Crpw, Division of Epidemiology, School of Public Health, University of Minnesota, 1300 South Second Street, Suit 300, Mineapolis, MN 55454 ( e-mail: crow©epi.umn.edu).
The Minnesota Code is the most widely used electrocardiogram (ECG) classification system for epidemiologic studies and has been incorporated into several computer alogorithms. the authors compared the Modular ECG Analysis System (MC-MEANS)and NOVACODE computer ECG findings with the Visual coding standard for agreement and prognostic associations with coronary hear dissease (CHD) events occurring during follow-up from 1987 to 1995 in 2,116 individuals participating in the Atherosclerosis Risk in Communities (ARIC) Study. The exact agreement between Visual and computer findings was greater than 90% for all Minnesota Code categories except Q-code, which was 77% for MC-MEANS and 81% for NOVACODE. Approximately 60% of all Q-codes were assigned by computer methods only. Among the 2,116 participants, there were 246 (11.6%) new coronary events. Unadjusted relative risks for codes assigned by the three methods were similar. When computer methods disagreed on code severity, the CHD occurrence rates for MC-MEANS-detected severer code versus NOVACODE-detected severer code were 21% and 7%, respectively. This study provides clear evidence that computers assign more and severer Minnesota Codes with similar prognostic importance as does the Visual method; it also alerts researchers to potential problems in pooling Minnesota Code data read by different methods. An J Epidemiol 2000; 151:790–7.
computing methodologies; coronary disease; electrocardiography; prognosis
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