Abstract
BackgroundValidation of recorded data is a prerequisite for studies that utilize administrative databases. The present study evaluated the validity of diagnoses and procedure records in the Japanese Diagnosis Procedure Combination (DPC) data, along with laboratory test results in the newly-introduced Standardized Structured Medical Record Information Exchange (SS-MIX) data.MethodsBetween November 2015 and February 2016, we conducted chart reviews of 315 patients hospitalized between April 2014 and March 2015 in four middle-sized acute-care hospitals in Shizuoka, Kochi, Fukuoka, and Saga Prefectures and used them as reference standards. The sensitivity and specificity of DPC data in identifying 16 diseases and 10 common procedures were identified. The accuracy of SS-MIX data for 13 laboratory test results was also examined.ResultsThe specificity of diagnoses in the DPC data exceeded 96%, while the sensitivity was below 50% for seven diseases and variable across diseases. When limited to primary diagnoses, the sensitivity and specificity were 78.9% and 93.2%, respectively. The sensitivity of procedure records exceeded 90% for six procedures, and the specificity exceeded 90% for nine procedures. Agreement between the SS-MIX data and the chart reviews was above 95% for all 13 items.ConclusionThe validity of diagnoses and procedure records in the DPC data and laboratory results in the SS-MIX data was high in general, supporting their use in future studies.
Highlights
Administrative databases are widely used in medical research studies.1e4 Their large sample size, population representativeness, and clinical information enables large-scale studies to be conducted inexpensively.[5,6] the use of administrative databases for research is based on an assumption that databases convey reasonably accurate data for health status and service utilization information
Comorbidities were recorded with high specificity, but their sensitivities were low and variable across different diseases.8e13 Studies have shown that, despite accurate recording of major procedures, such as surgeries and invasive examinations, minor procedures not related to reimbursements were often under-reported.14e16 literature on validation studies is sparse compared with the widespread application of databases, and administrative database research has often used non-validated diagnostic or procedural codes.[17]
Laboratory data collected from the Standardized Structured Medical Record Information Exchange (SS-MIX) storage at each hospital and Diagnosis Procedure Combination (DPC) data extracted from the Medical Information Analysis (MIA) databank were compared with chart review results
Summary
Administrative databases are widely used in medical research studies.1e4 Their large sample size, population representativeness, and clinical information enables large-scale studies to be conducted inexpensively.[5,6] the use of administrative databases for research is based on an assumption that databases convey reasonably accurate data for health status and service utilization information. Because the use of inaccurate data could produce biased results,[6,7] validation of the information recorded in administrative databases is essential. The Japanese Diagnosis Procedure Combination (DPC) database has been widely used in clinical epidemiology studies.18e21 The DPC data are unique in that distinctions are made between main diagnosis, comorbidities, and complications, and unlimited numbers of procedures and medications can be recorded.[22] In addition, the National Hospital Organization (NHO) introduced the Standardized. The present study evaluated the validity of diagnoses and procedure records in the Japanese Diagnosis Procedure Combination (DPC) data, along with laboratory test results in the newly-introduced Standardized Structured Medical Record Information Exchange (SS-MIX) data. Conclusion: The validity of diagnoses and procedure records in the DPC data and laboratory results in the SS-MIX data was high in general, supporting their use in future studies
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