Accuracy of Japanese claims data in identifying diabetes-related complications
Accuracy of Japanese claims data in identifying diabetes-related complications
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DOI：
10.1002/pds.5213
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发表时间：
2021-03-04
影响因子：
2.6
通讯作者：
Sone, Hirohito
中科院分区：
文献类型：
--
作者：
Fujihara, Kazuya;Yamada-Harada, Mayuko;Sone, Hirohito
目的 评估糖尿病相关并发症（冠状动脉疾病 [CAD]、心力衰竭、脑血管疾病和透析）的各种基于索赔的定义的准确性。 方法 我们评估了 2018 年 9 月在新泻大学医科牙科医院接受治疗的 1379 名住院患者的数据。对所有患者的糖尿病相关并发症进行了手动电子病历审查，并将其作为金标准。计算基于诊断程序组合 (DPC)、国际疾病分类第十次修订版 (ICD-10) 代码、程序代码和药物代码的与糖尿病相关并发症相关的每个基于索赔的定义的敏感性、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV)。结果基于 DPC 的定义对于 CAD 和脑血管疾病比 ICD-10 代码定义具有更高的敏感性、特异性和 PPV，敏感性为0.963-1.000和0.905-0.952，特异性分别为1.000和1.000，PPV分别为1.000和1.000。使用 CAD 和透析程序代码，敏感性、特异性和 PPV 都很高，敏感性分别为 0.963 和 1.000，特异性为 1.000 和 1.000，PPV 分别为 1.000 和 1.000。 DPC 和/或 ICD-10 代码 + 药物治疗心力衰竭比 ICD-10 代码定义更好，敏感性为 0.933，特异性为 1.000，PPV 为 1.000。仅使用 ICD-10 代码，所有糖尿病相关并发症的 PPV 均低于 60%。 结论 基于 DPC 的 CAD 和脑血管疾病定义、CAD 和透析程序代码以及心力衰竭药物代码的 DPC 或 ICD-10 代码可以从理赔数据库中准确识别这些糖尿病相关并发症。
Purpose To evaluate the accuracy of various claims-based definitions of diabetes-related complications (coronary artery disease [CAD], heart failure, cerebrovascular disease and dialysis).Methods We evaluated data on 1379 inpatients who received care at the Niigata University Medical & Dental Hospital in September 2018. Manual electronic medical chart reviews were conducted for all patients with regard to diabetes-related complications and were used as the gold standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each claims-based definition associated with diabetes-related complications based on Diagnosis Procedure Combination (DPC), International Classification of Diseases, Tenth Revision (ICD-10) codes, procedure codes and medication codes were calculated.Results DPC-based definitions had higher sensitivity, specificity, and PPV than ICD-10 code definitions for CAD and cerebrovascular disease, with sensitivity of 0.963-1.000 and 0.905-0.952, specificity of 1.000 and 1.000, and PPV of 1.000 and 1.000, respectively. Sensitivity, specificity, and PPV were high using procedure codes for CAD and dialysis, with sensitivity of 0.963 and 1.000, specificity of 1.000 and 1.000, and PPV of 1.000 and 1.000, respectively. DPC and/or ICD-10 codes + medication were better for heart failure than the ICD-10 code definition, with sensitivity of 0.933, specificity of 1.000, and PPV of 1.000. The PPVs were lower than 60% for all diabetes-related complications using ICD-10 codes only.Conclusion The DPC-based definitions for CAD and cerebrovascular disease, procedure codes for CAD and dialysis, and DPC or ICD-10 codes with medication codes for heart failure could accurately identify these diabetes-related complications from claims databases.