With the introduction of tenth revision of the International Classification of Disease (ICD-10) coding system by the World Health Organization (WHO) in 1992, this risk adjustment tool may no longer be valid. Hence, Canada has accepted Tu's risk adjustment method to generate public reports of AMI outcomes. These authors found that Tu's method performed better than other general methods that summarized comorbidities as a score, or included comorbidities that are less relevant for AMI outcomes. compared Tu et al's disease specific prediction rule to many other methods. Subsequently, many studies have assessed its validity and employed the AMI prediction method. Along with adjustments for sex and age, these 9 comorbidities were found to substantially predict AMI mortality in Ontario provincial database, and were validated in 2 external databases from Manitoba, Canada and California, the United States. The nine comorbidities were chosen from the 43 comorbidities based on their clinical plausibility and statistical significance. initially selected 43 comorbidities that were used as potential risk factors for AMI in United States hospital report cards. To develop such a tool for AMI patients, Tu et al. Risk adjustment is an important tool used in health service research to account for differences in AMI patient's characteristics. Acute myocardial infarction (AMI) outcomes are studied frequently in health service research with hospital discharge administrative data.
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