{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:43:23Z","timestamp":1789130603672,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Contemporary epidemiologic research on acute myocardial infarction (AMI) using electronic health records (EHR) relies on International Classification of Diseases, 10th Revision, Clinical Modification (ICD\u201010\u2010CM) codes, but limited studies have been conducted to validate these codes in the United States. Therefore, this study aimed to validate AMI events identified by ICD\u201010\u2010CM diagnosis codes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was conducted as part of a hepatitis B vaccine safety study. Suspected cases of AMI were identified using ICD\u201010\u2010CM codes (I21.* or I22.*) in any diagnosis position from August 7, 2018 to November 30, 2020. Cases were adjudicated independently by two cardiologists, with a third resolving disagreements. Positive predictive value (PPV) was calculated as the percentage of suspected cases that were confirmed as definite or probable AMI on review, and exact binomial 95% confidence intervals (CI) were estimated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 202 potential AMI events identified among 69\u2009625 individuals, 162 (80.2% [95% CI: 74.0%\u201385.5%]) were confirmed. Encounters with AMI coded as the principal discharge diagnosis code were more likely to be confirmed (86.8% [80.5%\u201391.6%]) than those with AMI in another diagnosis position (55.8% [39.9%\u201370.9%]), while patients with a history of congestive heart failure and peripheral vascular disease had lower PPV compared to those without (83.2% [76.7%\u201388.6%] and 82.9% [76.4%\u201388.3%], respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that over 80% of AMI cases identified with ICD\u201010\u2010CM codes were confirmed upon cardiologist adjudication. Cases not coded in the principal diagnosis position were much less likely to be confirmed, and care should be taken when using them in EHR\u2010based research.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70179","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T08:29:28Z","timestamp":1750753768000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Validation of <scp>ICD<\/scp>\u201010 Diagnosis Codes for Identification of Acute Myocardial Infarction From a US Integrated Healthcare System"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6108-9198","authenticated-orcid":false,"given":"Jeff","family":"Slezak","sequence":"first","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia J.","family":"Bruxvoort","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"},{"name":"Department of Epidemiology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina S.","family":"Sy","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley K.","family":"Ackerson","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Y.\u2010J.","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kaiser Permanente Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Sum","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kaiser Permanente Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kaiser Permanente Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijia","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zendi","family":"Solano","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation Kaiser Permanente Southern California  Pasadena California USA"},{"name":"Department of Health Systems Science Kaiser Permanente Bernard J. Tyson School of Medicine  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Acute Myocardial Infarction","author":"Mechanic O. 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