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

Author

Listed:
  • Nobuhiro Ooba
  • Soko Setoguchi
  • Takashi Ando
  • Tsugumichi Sato
  • Takuhiro Yamaguchi
  • Mayumi Mochizuki
  • Kiyoshi Kubota

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.

Suggested Citation

  • Nobuhiro Ooba & Soko Setoguchi & Takashi Ando & Tsugumichi Sato & Takuhiro Yamaguchi & Mayumi Mochizuki & Kiyoshi Kubota, 2013. "Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-7, May.
  • Handle: RePEc:plo:pone00:0066116
    DOI: 10.1371/journal.pone.0066116
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    Cited by:

    1. Alvin Ho-ting Li & S Joseph Kim & Jagadish Rangrej & Damon C Scales & Salimah Shariff & Donald A Redelmeier & Greg Knoll & Ann Young & Amit X Garg, 2013. "Validity of Physician Billing Claims to Identify Deceased Organ Donors in Large Healthcare Databases," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-6, August.
    2. Takahashi, Yoshimitsu & Ishizaki, Tatsuro & Nakayama, Takeo & Kawachi, Ichiro, 2016. "Social network analysis of duplicative prescriptions: One-month analysis of medical facilities in Japan," Health Policy, Elsevier, vol. 120(3), pages 334-341.
    3. Aziz Jamal & Akira Babazono & Yunfei Li & Takako Fujita & Shinichiro Yoshida & Sung A Kim, 2021. "Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-21, May.

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