Assembling and validating a heart failure-free cohort from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study

• Published in: BMC medical research methodology 2020-03, Vol.20 (1), p.53-53, Article 53
• Main Authors: Goyal, Parag, Mefford, Matthew T, Chen, Ligong, Sterling, Madeline R, Durant, Raegan W, Safford, Monika M, Levitan, Emily B
• Format: Article
• Language: English
• Subjects: African Americans; African Americans - statistics & numerical data; Age; Aged; Blood pressure; Cardiac arrhythmia; Cardiovascular research; Cohort Studies; Demographic aspects; Epidemiology; Female; Future predictions; Geography; Heart failure; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - ethnology; Humans; Hypertension; Inpatients - statistics & numerical data; Male; Medical records; Medical research volunteers; Medicare; Medicare - statistics & numerical data; Methods; Middle Aged; Outpatients - statistics & numerical data; Population studies; Population Surveillance - methods; Race; Racial differences; Recruiting; Reproducibility of Results; Stroke; Stroke - diagnosis; Stroke - epidemiology; Stroke - ethnology; Time; Torsemide; United States - epidemiology; Whites - statistics & numerical data
• ISSN: 1471-2288; 1471-2288
• DOI: 10.1186/s12874-019-0890-x

Studies examining incident heart failure (HF) have been limited to select populations. To examine incident HF with broader generalizability, there is need to assemble a HF-free cohort using a geographically-diverse sample. We aimed to develop and validate a simple medication-based strategy for assembling a HF-free cohort from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. We examined REGARDS participants with ≥6 months of Medicare inpatient and outpatient claims data at the time of the baseline in-home study examination. To assemble a HF-free cohort, we identified and excluded participants taking HF-specific medications. To validate this approach, we evaluated event rates among this cohort and assessed diagnostic performance using Medicare claims-based definitions of HF as the referent standard. Among 28,884 eligible participants, 3125 were excluded from the proposed HF-free cohort, leaving a total of 25,759 (89%) participants. Depending on the Medicare definition used as the referent, the negative predictive value of this approach ranged from 95.0-99.2%. Negative predictive value was stable across age, sex, and race strata. The approach to assemble a HF-free cohort in REGARDS can serve as the basis for future studies to examine incident HF in REGARDS and similar studies.