Table 1:

Case definitions of heart failure used in the British Columbia node of the Canadian Primary Care Sentinel Surveillance Network

DefinitionConditions that must be met for a patient to be classified as having heart failure
1.1. Nova Scotia MaRNet-FP
  • ≥ 1 ICD-9 diagnostic codes in EMR health condition table or EMR encounter diagnosis table (Appendix 3) OR

  • Combination of ATC codes in the medication table in Appendix 4: (ACE inhibitor or ARB) and β-blocker and diuretic

1.2. Identical to 1.1 but also searching billings
  • ≥ 1 ICD-9 diagnostic codes in EMR health condition table or EMR encounter diagnosis table or EMR billings table (Appendix 3) OR

  • Combination of ATC codes in the medication table in Appendix 4: (ACE inhibitor or ARB) and β-blocker and diuretic

2.1. ICD-9 AND ATC codes
Also revised ICD-9 and ATC codes
  • ≥ 1 ICD-9 codes in EMR health condition table or EMR encounter diagnosis table or EMR billings table (Appendix 5) AND

  • ≥ 1 ATC code for any ACE Inhibitor or any ARB or β-blocker or MRA or hydralazine (medication table in Appendix 4)

Definition 2.2
Subset of 2.1, diagnoses only
  • ≥ 1 ICD-9 codes in EMR health condition table or EMR encounter diagnosis table or EMR billings table (Appendix 5)

Definition 2.3
Require 2 codes separated in time
  • ≥ 2 ICD-9 codes (Appendix 5) in EMR health condition table, EMR encounter diagnosis table and EMR billings table combined, separated by ≥ 30 d

Definition 2.4
Specific therapies for heart failure
  • ≥ 1 ATC code for sacubitril–valsartan OR

  • Combination of ATC codes for (ACE inhibitor or ARB) and β-blocker and MRA (medication table in Appendix 4)

Definition 2.5Definition 2.1 OR Definition 2.3 OR Definition 2.4
Definition 3.1Definition 2.1 with furosemide and without EMR billings table, as follows:
  •  ≥ 1 ICD-9 codes in EMR health condition table or EMR encounter diagnosis table (Appendix 5) AND

  •  ≥ 1 ATC code for any ACE inhibitor or any ARB or β-blocker or MRA or hydralazine or furosemide; as listed in the medication table in Appendix 4 OR

  • Definition 2.3 without EMR billings table: ≥ 2 ICD-9 codes (Appendix 5) in EMR health condition table or EMR encounter diagnosis table, separated by ≥ 30 d OR

  • Definition 2.4

Definition 3.2
  • Definition 2.1 with furosemide, as follows:

    • ≥ 1 ICD-9 codes in EMR health condition table or EMR encounter diagnosis table or EMR billings table (Appendix 5) AND

    • ≥ 1 ATC code for any ACE inhibitor or any ARB or β-blocker or MRA or hydralazine or furosemide; as listed in the medication table in Appendix 4 OR

  • Definition 2.3 OR

  • Definition 2.4

Definition 4.1
Low-threshold BNP
  • Definition 1.1 OR

  • BNP > 50 or NT-proBNP > 125

Definition 4.2
  • Definition 1.2 OR

  • BNP > 50 or NT-proBNP > 125

Definition 4.3
  • Definition 3.2 OR

  • BNP > 50 or NT-proBNP > 125

Definition 5.1
High-threshold BNP
  • Definition 1.1 OR

  • BNP > 400 or NT-proBNP > 450 for patients aged < 50 yr, > 900 for patients aged 50–75 yr, >1800 for patients aged > 75 yr

Definition 5.2
  • Definition 1.2 OR

  • BNP > 400 or NT-proBNP > 450 for patients aged < 50 yr, > 900 for patients aged 50–75 yr, >1800 for patients aged > 75 yr

Definition 5.3
  • Definition 3.2 OR

  • BNP > 400 or NT-proBNP > 450 for patients aged < 50 yr, > 900 for patients aged 50–75 yr, >1800 for patients aged > 75 yr

  • Note: ACE = angiotensin-converting-enzyme, ARB = angiotensin II receptor blocker, ATC = Anatomical Therapeutic Chemical, BNP = brain natriuretic peptide, EMR = electronic medical record, ICD-9 = International Classification of Diseases, Ninth Revision, MAR-net = Maritime Family Practice Research Network, MRA = mineralocorticoid receptor antagonists; NT-proBNP = N-terminal pro brain natriuretic peptide.