Outcome
Our primary outcome was the period prevalence of CV testing. We defined
CV as having an echocardiogram or stress test 1 year before the SCD
score and 2 years after the score. The rationale for including
echocardiograms and stress tests is that they represent the most
commonly initial tests used in cardiology. We did not include
electrocardiograms as the rate was low and the possibility of
undercoding. We defined having an echocardiogram or stress test done by
the CPT code. (see table 1 supplementary appendix). The validity of
these codes has been previously validated.14
Our secondary outcome was all cause mortality. The database captures
mortality via the National Technical Information Service (NTIS) Limited
Access Death Master File (LAMDF) as well as from an institutionally
generated death flag within the EHR system.