Association measures of claims-based algorithms for common chronic conditions were assessed using regularly collected data in Japan

Hara, Kozo; Tomio, Jun; Svensson, Thomas; Ohkuma, Rika; Svensson, Akiko Kishi; Yamazaki, Tsutomu

doi:10.1016/j.jclinepi.2018.03.004

Cited by 38 publications

(45 citation statements)

References 38 publications

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“…The JMDC Claims Database began collecting claims data in 2005 and the number of beneficiaries has increased gradually in the past decade (248,552 beneficiaries in 2005 and 2,448,581 beneficiaries in 2015). The validity of claim-based patient identification using this database has been reported with regard to diabetes, hypertension, and dyslipidemia [29]. We observed 10 fiscal years that were divided into five periods; (1) April 2006 to March 2008, (2) April 2008 to March 2010, (3) April 2010 to March 2012, (4) April 2012 to March 2014, and (5) April 2014 to March 2016.…”

Section: Methodsmentioning

confidence: 93%

“…We identified patients with antidiabetic medication based on at least one prescription during the subject-identification year. We finally identified patients with diabetes using a combination of the diagnosis of diabetes and prescription of antidiabetic medication to increase the specificity of case detection at the expense of sensitivity [26,29].…”

Section: Identification Of Patients With Antidiabetic Medicationmentioning

confidence: 99%

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Changes in the quality of diabetes care in Japan between 2007 and 2015: A repeated cross-sectional study using claims data

Tanaka

Sugiyama

Ihana‐Sugiyama

et al. 2019

Diabetes Research and Clinical Practice

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To assess the temporal changes in the quality indicators pertaining to the process measures of diabetes care during a recent decade in Japan. Methods: A five-fold repeated cross-sectional study was conducted using health insurance claims data provided by the Japan Medical Data Center between April 2006 and March 2016. We identified 46,631 outpatients with antidiabetic medication who regularly visited hospitals or clinics at least every three months. We evaluated the quality indicators pertaining to glycemic control monitoring, lipid profile monitoring, retinopathy screening, nephropathy screening, and appropriate medication choice. The proportions of patients who received appropriate examinations/prescriptions, by observation period and either the type of antidiabetic medication or facility type were estimated using generalized estimating equation (GEE) models with multiple covariate adjustments. Results: The quality indicator values for appropriate medication choice and nephropathy screening improved between 2007 and 2015, whereas those for glycemic control monitoring and retinopathy screening remained suboptimal. Patients prescribed medications in larger hospitals were likelier to undergo the recommended examinations (e.g. retinopathy screening: 36.1% (95% CI: 35.4-36.7%) for clinic, 40.6% (95% CI: 39.1-42.2%) for smaller hospital, and 46.0% (95% CI: 44.8-47.2%) for larger hospital in 2015). Conclusions: Several process measures of diabetes care remained suboptimal in Japan.

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Section: Methodsmentioning

confidence: 93%

Section: Identification Of Patients With Antidiabetic Medicationmentioning

confidence: 99%

Changes in the quality of diabetes care in Japan between 2007 and 2015: A repeated cross-sectional study using claims data

Tanaka

Sugiyama

Ihana‐Sugiyama

et al. 2019

Diabetes Research and Clinical Practice

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“…As with the claims data, the validity of the accuracy of each data component (e.g., chief complaints) is critical to undertaking high-quality study. 17 To address the knowledge gap in published reports, we investigated whether the NSER system accurately translated EMRs into corresponding categories or codes using chart review results as the gold standard. The assessed data components for each case were chief complaints, medical history, medications, and physician's diagnoses at the ED.…”

Section: Introductionmentioning

confidence: 99%

Validation of chief complaints, medical history, medications, and physician diagnoses structured with an integrated emergency department information system in Japan: the Next Stage ER system

Goto

Hara

Hashimoto

et al. 2020

Acute Medicine & Surgery

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Aim Emergency department information systems (EDIS) facilitate free‐text data use for clinical research; however, no study has validated whether the Next Stage ER system (NSER), an EDIS used in Japan, accurately translates electronic medical records (EMRs) into structured data. Methods This is a retrospective cohort study using data from the emergency department (ED) of a tertiary care hospital from 2018 to 2019. We used EMRs of 500 random samples from 27,000 ED visits during the study period. Through the NSER system, chief complaints were translated into 231 chief complaint categories based on the Japan Triage and Acuity Scale. Medical history and physician’s diagnoses were encoded using the International Classification of Diseases, 10th Revision; medications were encoded as Anatomical Therapeutic Chemical Classification System codes. Two reviewers independently reviewed 20 items (e.g., presence of fever) for each study component (e.g., chief complaints). We calculated association measures of the structured data by the NSER system, using the chart review results as the gold standard. Results Sensitivities were very high (>90%) in 17 chief complaints. Positive predictive values were high for 14 chief complaints (≥80%). Negative predictive values were ≥96% for all chief complaints. For medical history and medications, most of the association measures were very high (>90%). For physicians’ ED diagnoses, sensitivities were very high (>93%) in 16 diagnoses; specificities and negative predictive values were very high (>97%). Conclusions Chief complaints, medical history, medications, and physician’s ED diagnoses in EMRs were well‐translated into existing categories or coding by the NSER system.

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“…The claims-based diagnoses might not be accurate enough. [ 16 , 17 ] However, relatively high accuracy of diagnostic codes of common chronic conditions in the JMDC Claims Database [ 32 ] may support our case identification strategy. Third, some relevant information, including maternal data, test results, disease severity, brain imaging, and laterality of symptoms and/or sequelae, as well as the examinations and treatments not covered by the insurance, were not available through the claims data.…”

Section: Discussionmentioning

confidence: 98%

Diagnosis and medical care for congenital cytomegalovirus infection

Lin

Tomio²,

Tanaka³

et al. 2020

Medicine

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Association measures of claims-based algorithms for common chronic conditions were assessed using regularly collected data in Japan

Cited by 38 publications

References 38 publications

Changes in the quality of diabetes care in Japan between 2007 and 2015: A repeated cross-sectional study using claims data

Changes in the quality of diabetes care in Japan between 2007 and 2015: A repeated cross-sectional study using claims data

Validation of chief complaints, medical history, medications, and physician diagnoses structured with an integrated emergency department information system in Japan: the Next Stage ER system

Diagnosis and medical care for congenital cytomegalovirus infection

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