Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications

Nobuhiro Ooba, Soko Setoguchi, Takashi Ando, Tsugumichi Sato, Takuhiro Yamaguchi, Mayumi Mochizuki, Kiyoshi Kubota

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: For the pending National Claims Database in Japan, researchers will not have access to death information in the enrollment files. We developed and evaluated a claims-based definition of death. Methodology/Principal Findings: We used healthcare claims and enrollment data between January 2005 and August 2009 for 195,193 beneficiaries aged 20 to 74 in 3 private health insurance unions. We developed claims-based definitions of death using discharge or disease status and Charlson comorbidity index (CCI). We calculated sensitivity, specificity and positive predictive values (PPVs) using the enrollment data as a gold standard in the overall population and subgroups divided by demographic and other factors. We also assessed bias and precision in two example studies where an outcome was death. The definition based on the combination of discharge/disease status and CCI provided moderate sensitivity (around 60%) and high specificity (99.99%) and high PPVs (94.8%). In most subgroups, sensitivity of the preferred definition was also around 60% but varied from 28 to 91%. In an example study comparing death rates between two anticancer drug classes, the claims-based definition provided valid and precise hazard ratios (HRs). In another example study comparing two classes of anti-depressants, the HR with the claims-based definition was biased and had lower precision than that with the gold standard definition. Conclusions/Significance: The claims-based definitions of death developed in this study had high specificity and PPVs while sensitivity was around 60%. The definitions will be useful in future studies when used with attention to the possible fluctuation of sensitivity in some subpopulations.

Original languageEnglish
Article numbere66116
JournalPLoS One
Volume8
Issue number5
DOIs
Publication statusPublished - 2013 May 31

Fingerprint

Hazards
Databases
Health insurance
death
gold
Comorbidity
health insurance
Access to Information
Pharmaceutical Preparations
antineoplastic agents
Health Insurance
health services
Japan
demographic statistics
researchers
Research Personnel
Demography
Outcome Assessment (Health Care)
Delivery of Health Care
Sensitivity and Specificity

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Ooba, N., Setoguchi, S., Ando, T., Sato, T., Yamaguchi, T., Mochizuki, M., & Kubota, K. (2013). Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications. PLoS One, 8(5), [e66116]. https://doi.org/10.1371/journal.pone.0066116

Claims-Based Definition of Death in Japanese Claims Database : Validity and Implications. / Ooba, Nobuhiro; Setoguchi, Soko; Ando, Takashi; Sato, Tsugumichi; Yamaguchi, Takuhiro; Mochizuki, Mayumi; Kubota, Kiyoshi.

In: PLoS One, Vol. 8, No. 5, e66116, 31.05.2013.

Research output: Contribution to journalArticle

Ooba, N, Setoguchi, S, Ando, T, Sato, T, Yamaguchi, T, Mochizuki, M & Kubota, K 2013, 'Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications', PLoS One, vol. 8, no. 5, e66116. https://doi.org/10.1371/journal.pone.0066116
Ooba N, Setoguchi S, Ando T, Sato T, Yamaguchi T, Mochizuki M et al. Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications. PLoS One. 2013 May 31;8(5). e66116. https://doi.org/10.1371/journal.pone.0066116
Ooba, Nobuhiro ; Setoguchi, Soko ; Ando, Takashi ; Sato, Tsugumichi ; Yamaguchi, Takuhiro ; Mochizuki, Mayumi ; Kubota, Kiyoshi. / Claims-Based Definition of Death in Japanese Claims Database : Validity and Implications. In: PLoS One. 2013 ; Vol. 8, No. 5.
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