Optimal use of available claims to identify a Medicare population free of coronary heart disease.

Academic Article


  • We examined claims-based approaches for identifying a study population free of coronary heart disease (CHD) using data from 8,937 US blacks and whites enrolled during 2003-2007 in a prospective cohort study linked to Medicare claims. Our goal was to minimize the percentage of persons at study entry with self-reported CHD (previous myocardial infarction or coronary revascularization). We assembled 6 cohorts without CHD claims by requiring 6 months, 1 year, or 2 years of continuous Medicare fee-for-service insurance coverage prior to study entry and using either a fixed-window or all-available look-back period. We examined adding CHD-related claims to our "base algorithm," which included claims for myocardial infarction and coronary revascularization. Using a 6-month fixed-window look-back period, 17.8% of participants without claims in the base algorithm reported having CHD. This was reduced to 3.6% using an all-available look-back period and adding other CHD claims to the base algorithm. Among cohorts using all-available look-back periods, increasing the length of continuous coverage from 6 months to 1 or 2 years reduced the sample size available without lowering the percentage of persons with self-reported CHD. This analysis demonstrates approaches for developing a CHD-free cohort using Medicare claims.
  • Published In


  • Medicare, algorithms, bias (epidemiology), coronary disease, epidemiologic methods, African Continental Ancestry Group, Aged, Aged, 80 and over, Algorithms, Bias, Coronary Artery Disease, European Continental Ancestry Group, Female, Humans, Male, Medicare, Middle Aged, Population Surveillance, Prospective Studies, United States
  • Digital Object Identifier (doi)

    Author List

  • Kent ST; Safford MM; Zhao H; Levitan EB; Curtis JR; Kilpatrick RD; Kilgore ML; Muntner P
  • Start Page

  • 808
  • End Page

  • 819
  • Volume

  • 182
  • Issue

  • 9