The validity of the claims-based definition of rheumatoid arthritis evaluated in 64 hospitals in Japan
| Autor: | Hitoshi Kohsaka, Satoru Takahashi, Kiyoshi Kubota, Yoshiaki Fujimura, Masaki Yoshizawa, Hiroko Nomura |
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| Rok vydání: | 2021 |
| Předmět: |
Positive predictive value
medicine.medical_specialty Population Diseases of the musculoskeletal system Negative predictive value Arthritis Rheumatoid Polymyalgia rheumatica 03 medical and health sciences Sensitivity 0302 clinical medicine Japan Rheumatology Internal medicine Epidemiology medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Rheumatoid arthritis Bias analysis education 030203 arthritis & rheumatology education.field_of_study business.industry Validation study medicine.disease Hospitals Clinical trial RC925-935 Antirheumatic Agents Specificity Population study Rheumatologists business Record linkage Research Article |
| Zdroj: | BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-11 (2021) BMC Musculoskeletal Disorders |
| ISSN: | 1471-2474 |
| DOI: | 10.1186/s12891-021-04259-9 |
| Popis: | Background An administrative database covering a whole population such as the national database in Japan may be used to estimate the nationwide prevalence of diseases including rheumatoid arthritis (RA) when a well-validated definition of the disease is available. In Japan, the record linkage between the administrative database and medical charts in hospitals is strictly prohibited. A “hospital-based” validation study is one of few possible validation studies where claims kept inside the study hospital are rearranged into the database structure. Methods We selected random samples of 19,734 patients from approximately 1.6 million patients who received medical care between February 2018 and January 2019 in one of the 64 hospitals of the Tokushukai Medical Group. We excluded patients whose observation period was less than 365 days and identified 334 patients who met the definition of “possible cases of RA” whose medical charts were then independently evaluated by two rheumatologists. In a sensitivity analysis, we assessed bias due to misclassifying some patients with RA who did not meet the definition of “possible cases of RA” as a patient with no RA. Results The kappa coefficient between the two rheumatologists was 0.80. The prevalence of RA in the study population was estimated to be 0.56%. We found that [condition code of RA] and ([any disease-modifying antirheumatic drug] or [oral corticosteroid with no systemic autoimmune diseases (other than RA) and no polymyalgia rheumatica]) had a relatively high sensitivity (approximately 73%) and a high positive predictive value (approximately 80%). In a sensitivity analysis, we found that when some patients with RA who did not meet the definition of “possible cases of RA” were misclassified as a patient with no RA, then this would lead to underestimation of the prevalence of the definition-positive patients and the adjusted prevalence. Conclusions We recommend using the claims-based definition of RA (found in the current validation study) to estimate the prevalence of RA in Japan. We also suggest estimating the adjusted prevalence using the quantitative bias analysis method, since the prevalence of the disease in the “hospital-based” validation study is different from that in the administrative database. Trial registration The current study is not a clinical trial and hence not subject to trial registration. |
| Databáze: | OpenAIRE |
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