ArticleClinical research in cardiology : official journal of the German Cardiac Society2018
Underestimated prevalence of heart failure in hospital inpatients: a comparison of ICD codes and discharge letter information.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Diagnostic accuracy of case-identification algorithms for heart failure in the general population using routinely collected health data: a systematic review.Systematic reviews · 2024Pooled it
- Accuracy of heart failure ascertainment using routinely collected healthcare data: a systematic review and meta-analysis.Systematic reviews · 2024Pooled it
- Systematic review of current natural language processing methods and applications in cardiology.Heart (British Cardiac Society) · 2022Pooled it
- Long-term effects of device-guided slow breathing in stable heart failure patients with reduced ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2019Trial
- Development of phenotype algorithms for the detection of adverse events in electronic health record data: a multicentre study.BMJ open · 2026Article
- Diagnosing post-capillary hypertension in patients with left heart disease: impact of new guidelines.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Case Ascertainment in Pediatric Heart Failure Using International Classification of Disease Clinical Modification (ICD-CM) Codes.Pediatric cardiology · 2025Article
- Acute heart failure in non-cardiac surgery.European heart journal · 2025Review
- MiR-21-3p inhibitor exerts myocardial protective effects by altering macrophage polarization state and reducing excessive mitophagy.Communications biology · 2024Article
- Improved Interpretation of Pulmonary Artery Wedge Pressures through Left Atrial Volumetry-A Cardiac Magnetic Resonance Imaging Study.Journal of cardiovascular development and disease · 2024Article
- Accuracy of VOHerz · 2024Article
- Artificial Intelligence Technologies in Cardiology.Journal of cardiovascular development and disease · 2023Review
- Querying a Clinical Data Warehouse for Combinations of Clinical and Imaging Data.Journal of digital imaging · 2023Article
- Current progress of ferroptosis in cardiovascular diseases.Frontiers in cardiovascular medicine · 2023Review
- Diagnostic signature for heart failure with preserved ejection fraction (HFpEF): a machine learning approach using multi-modality electronic health record data.BMC cardiovascular disorders · 2022Article
- Administrative Data in Cardiovascular Research-A Comparison of Polish National Health Fund and CRAFT Registry Data.International journal of environmental research and public health · 2022Article
- Canagliflozin mitigates ferroptosis and ameliorates heart failure in rats with preserved ejection fraction.Naunyn-Schmiedeberg's archives of pharmacology · 2022Article
- Impact of Managing Provider Type on Severe Aortic Stenosis Management and Mortality.Journal of the American Heart Association · 2022Article
- Article
- Clinical implications of the universal definition for the prevention and treatment of heart failure.Clinical cardiology · 2022Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHeart failure is the predominant cause of hospitalization and amongst the leading causes of death in Germany. However, accurate estimates of prevalence and incidence are lacking. Reported figures originating from different information sources are compromised by factors like economic reasons or documentation quality.
methodsWe implemented a clinical data warehouse that integrates various information sources (structured parameters, plain text, data extracted by natural language processing) and enables reliable approximations to the real number of heart failure patients. Performance of ICD-based diagnosis in detecting heart failure was compared across the years 2000-2015 with (a) advanced definitions based on algorithms that integrate various sources of the hospital information system, and (b) a physician-based reference standard.
resultsApplying these methods for detecting heart failure in inpatients revealed that relying on ICD codes resulted in a marked underestimation of the true prevalence of heart failure, ranging from 44% in the validation dataset to 55% (single year) and 31% (all years) in the overall analysis. Percentages changed over the years, indicating secular changes in coding practice and efficiency. Performance was markedly improved using search and permutation algorithms from the initial expert-specified query (F1 score of 81%) to the computer-optimized query (F1 score of 86%) or, alternatively, optimizing precision or sensitivity depending on the search objective.
conclusionsEstimating prevalence of heart failure using ICD codes as the sole data source yielded unreliable results. Diagnostic accuracy was markedly improved using dedicated search algorithms. Our approach may be transferred to other hospital information systems.
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Registered trials
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