A team of Pitt and UPMC investigators used diagnosis codes from administrative data to identify a large cohort of patients with heart failure. In this study, all hospital encounters with heart failure between 2008 and 2015 were assigned an ICD-9 heart failure code. These were further stratified into three categories: heart failure with reduced ejection fraction, heart failure with preserved ejection fraction, and heart failure of unspecified type. Lead author Dr. Ahmad Masri notes that “using over 20,000 unique encounters of heart failure patients, we found that heart failure coding shifted over time from heart failure of unspecified type toward heart failure with reduced and preserved ejection fraction. While this suggests that coding became more precise and accurate, it also reveals the limitations in using administrative data alone to evaluate our patients.”

Senior author Dr. Suresh Mulukutla, says, “In the era of big data, there’s a natural excitement to use administrative coding data for analysis, but we must recognize that coding data may change over time and it must be used cautiously. However, our team works closely with the cutting-edge UPMC Clinical Analytics program, led by Dr. Oscar Marroquin, to combine administrative data with clinical and outcome data, with vast potential to better define our patient populations so that we can understand our data and develop effective pathways to deliver patient-centric care.”

Masri A, Althouse AD, McKibben J, Lee JS, Mulukutla S. Limitations of Administrative Data for Studying Patients Hospitalized With Heart Failure. Ann Intern Med. 2017 Jun 20;166(12):916-917. doi: 10.7326/L17-0077. PMID: 28462427