Validating Acute Coronary Syndrome ICD Codes as Training Labels for Clinical AI
This 10-year retrospective study of nearly 620,000 emergency department encounters validates that while ICD-coded Acute Coronary Syndrome labels exhibit high sensitivity and specificity, their moderate positive predictive value is driven by systematic, interpretable errors—primarily suspected cases later ruled out or coder omissions—making them suitable training labels for AI screening models where missing a diagnosis is more critical than over-identification.