@article {9063, title = {Comparison of self-reported and Medicare claims-identified acute myocardial infarction.}, journal = {Circulation}, volume = {131}, year = {2015}, month = {2015 Apr 28}, pages = {1477-85; discussion 1485}, abstract = {

BACKGROUND: Cardiovascular disease is often studied through patient self-report and administrative data. However, these 2 sources provide different information, and few studies have compared them.

METHODS AND RESULTS: We compared data from a longitudinal, nationally representative survey of older Americans with matched Medicare claims. Self-reported heart attack in the previous 2 years was compared with claims-identified acute myocardial infarction (AMI) and acute coronary syndrome. Among the 3.1\% of respondents with self-reported heart attack, 32.8\% had claims-identified AMI, 16.5\% had non-AMI acute coronary syndrome, and 25.8\% had other cardiac claims; 17.3\% had no inpatient visits in the previous 2.5 years. Claims-identified AMIs were found in 1.4\% of respondents; of these, 67.8\% reported a heart attack. Self-reports were less likely among respondents >75 years of age (62.7\% versus 74.6\%; P=0.006), with less than high school education (61.6\% versus 71.4\%; P=0.015), with at least 1 limitation in activities of daily living (59.6\% versus 74.7\%; P=0.001), or below the 25th percentile of a word recall memory test (60.7\% versus 71.3\%; P=0.019). Both self-reported and claims-identified cardiac events were associated with increased mortality; the highest mortality was observed among those with claims-identified AMI who did not self-report (odds ratio, 2.8; 95\% confidence interval, 1.5-5.1) and among those with self-reported heart attack and claims-identified AMI (odds ratio, 2.5; 95\% confidence interval, 1.7-3.6) or non-AMI acute coronary syndrome (odds ratio, 2.7; 95\% confidence interval, 1.8-4.1).

CONCLUSIONS: There is considerable disagreement between self-reported and claims-identified events. Although self-reported heart attack may be inaccurate, it indicates increased risk of death, regardless of whether the self-report is confirmed by Medicare claims.

}, keywords = {Heart disease, Medicare linkage, Medicare/Medicaid/Health Insurance, Self-reported health}, issn = {1524-4539}, doi = {10.1161/CIRCULATIONAHA.114.013829}, author = {Laura Yasaitis and Lisa F Berkman and Chandra, Amitabh} }