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This report describes the performance of a surveillance system and computerized algorithm for the assignment of definite or probable hospitalized cardiac events for large epidemiologic studies. The algorithm, developed by the Coordinating Committee for Community Demonstration Studies (CCCDS), evolved from the Gillum criteria, and included selected ICD-9-CM codes including codes 410 through 414 for discharge record screening, plus creatine kinase. For the small percentage of cases in which enzyme analysis was inconclusive (8%), presence of pain and/or Minnesota-coded electrocardiograms were included to define the outcome. All data items were easily obtained from medical records by trained lay record abstractors and required no interpretation. From January 1980 through December 1991, 21,183 medical records were screened for ICD-9-CM codes 410 through 414. Of all 410 to 411 ICD-9-CM codes (n = 9026), 36.9% (n = 3220) were classified as definite cardiac events and 10.6% (n = 1057) as probable events. Of all 412 through 414 codes (n = 9070), only 1.8% (n = 227) were classified as definite cardiac events and 5.4% (n = 716) as probable events. The epidemiologic diagnostic algorithm presented in this article used computerized data to assign diagnoses in a standard, objective manner, and was a lower cost alternative to classification of cardiac events on the basis of clinical review and/or more complex record abstraction approaches.

Objective: Previous studies based on 24-hour dietary recall data have shown that smokers tend to consume less healthful diets than nonsmokers. We tested this hypothesis using data from food frequency questionnaires (FFQs) in a group of men and women., Design: Characteristics of smokers and nonsmokers were compared using data collected from a cross-sectional household health survey., Subjects: Adults aged 18 through 64 years from two communities in southeastern New England were randomly selected for the study and interviewed in their homes by trained personnel. The interview included questions on demographic and behavioral characteristics. Height, weight, blood pressure, and serum lipids were measured using standard protocols. The Willett FFQ was completed by 1,608 of 2,531 eligible respondents who made up our study sample., Statistical Analyses Performed: Respondents were categorized as current cigarette smokers or nonsmokers. Demographic, behavioral, physiologic, and dietary characteristics were compared between smokers and nonsmokers by analysis of covariance with age as the covariate., Results: Eligible respondents who did not complete the FFQ differed from respondents with respect to age, gender, smoking prevalence, and several other demographic characteristics. Smokers consumed more energy, fat, alcohol, and caffeine than nonsmokers. Smoking status was inversely associated with intake of vitamins A and C, dietary fiber, folate, and iron among women, whereas differences were smaller and not significant among men. Women who smoked consumed fewer servings of fruits and vegetables than nonsmokers, but this trend was not noted in men. The association between diet and smoking was only slightly diminished by multivariate adjustment for age, income, regular exercise, marital status, and working status but most clinically relevant associations remained. The interaction between gender and smoking was not statistically significant for most dietary variables., Conclusions: These results suggest that health promotion messages targeted to smokers should include dietary instructions, especially for women.