A Review of Research Studies Using Data from the Administrative Claims Databases in Japan

Abstract

Background In Japan, several research studies have used administrative claims databases. However, no study has compared the studies conducted in each database. Objective We assessed the type, design, and research area of each research study using the administrative databases in Japan to illustrate the suitability of the database used for the types of research studies. Methods We reviewed studies from four administrative claims databases (the Japanese National Database of Health Insurance Claims and Specific Health Checkups [NDB]; the DPC Study Group database [DPC]; Japan Medical Data Center [JMDC]; and Medical Data Vision [MDV]). The PubMed database was searched from January 2015 to October 2020. We assessed the type, design, and research area of the abstract or full text of each research study. Results Overall, 643 studies were included. The number of studies increased from 59 in 2015 to 171 in 2020. Descriptive studies accounted for 62.7% (42 studies) of the studies from the NDB, while the treatment effectiveness studies accounted for 81.7% (211 studies) of the studies from the DPC database and were the most common in the JMDC and MDV. Cohort studies accounted for only 17.9% of the studies on NDB but 45.5% on DPC. The most common research area was medicine, general, and internal medicine (53 studies, 8.4%). Conclusions The type and design of the studies conducted differed in each database and were influenced by the characteristics of the database used. In the future, it may be necessary to integrate various real-world data databases to increase their comprehensiveness. Supplementary Information The online version contains supplementary material available at 10.1007/s40801-022-00331-5.

Combined effects of blood pressure and glycemic status on risk of heart failure: a population-based study

“…Nevertheless, there are some limitations. First, although information on participants was based on a database of a Japan-supported social insurance organization and health checkups [23], selection bias should be of concern since the participants were employees of various companies and some of their dependents. Moreover, only participants who underwent physical examinations accompanied by blood tests were included in the analysis.…”

The Current Status of Secondary Use of Claims, Electronic Medical Records, and Electronic Health Records in Epidemiology in Japan: Narrative Literature Review

“…In this subsection, we compare this review with 2 similar studies [ 27 , 28 ]. Hirose et al [ 27 ] conducted a narrative review of 68 studies on the secondary use of claims data in a specific database, NDB, from October 2016 to June 2019.…”

“…They summarized 5 key pieces of information, including study design, research area, setting or sample, outcomes, and strengths and limitations. Subsequently, Fujinaga and Fukuoka [ 28 ] conducted a similar narrative review of 643 studies on the secondary use of claims data in 4 large-scale domestic databases: NDB, DPC database (MHLW), JMDC, and MDV, from January 2015 to October 2020, from which 3 categories of research type, design, and area were analyzed descriptively. Both studies used a classification of the journals in which the target articles were published to extract information about the research area [ 29 ].…”

Strategies to Address Current Challenges in Real-World Evidence Generation in Japan

“…Depending on the level of information on confounders available in the data and the study design, methods such as instrumental variable (IV) methods [ 61 ], difference-in-difference [ 62 ], missing cause [ 63 ], trend-in-trend [ 64 ], and perturbation variable [ 65 ] may be appropriate. Studies using Japanese databases with such quasi-experimental designs accounted for 22.1% (142/643) of all the studies using RWD reported from 2015 to 2020 [ 7 ]. Few Japanese studies used quasi-experimental designs other than propensity score methods.…”

“…Most studies using RWD from MDV and JMDC focus on describing patient characteristics and treatment patterns since such RWD sources contain little information on clinical characteristics and outcomes [ 4 ]. A recent review that assessed the types of studies conducted between 2015 and 2020 using claims databases in Japan found that descriptive studies were the most common, accounting for 63%, 43%, and 41% of the studies conducted using NDB, MDV, and JMDC data, respectively [ 7 ]. To address this issue of missing data and to create a high-quality medical information database for conducting rigorous assessments of drug safety, the Medical Information Database Network (MID-NET) was launched in April 2018, in collaboration with 23 hospitals from 10 healthcare organizations across Japan.…”