Comparison of Computer-assigned Minnesota Codes with the Visual Standard Method for New Coronary Heart Disease Events

• Published in: American journal of epidemiology Vol. 151; no. 8; pp. 790 - 797
• Main Authors: Kors, Jan A., Crow, Richard S., Hannan, Peter J., Rautaharju, Pentti M., Folsom, Aron R.
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15.04.2000
• Subjects: Algorithms; Arteriosclerosis - diagnosis; Arteriosclerosis - pathology; Biological and medical sciences; Cardiology. Vascular system; Computerized, statistical medical data processing and models in biomedicine; computing methodologies; coronary disease; Coronary Disease - diagnosis; Coronary Disease - pathology; Coronary heart disease; Diagnosis, Computer-Assisted; Electrocardiography; Female; Heart; Humans; Male; Medical management aid. Diagnosis aid; Medical sciences; Middle Aged; Prognosis; Sensitivity and Specificity; Severity of Illness Index; Human; Analysis method; Prognosis; Classification; Electrocardiography; Cardiovascular disease; Diagnosis; Technique; Coronary heart disease; Computer aided analysis
• ISSN: 0002-9262; 1476-6256; 1476-6256
• DOI: 10.1093/oxfordjournals.aje.a010279

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.