Ishikawa Koichi Benjamin
Head, Economics Section, Division of Surveillance, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan (
Japan Med Assoc J. 2016 Sep 1;59(2-3):110-124. eCollection 2016 Sep.
Advances in the computerization of information and development of technology have mitigated restrictions on handling of a large amount of information. This has resulted in growth of expectations for the use of large-scale databases, or so-called "big data." This is also the case in the field of healthcare. Projects that involve building of the national receipt database (NDB) of medical fee bill (receipt) information and special health check-up information based on the Act on Assurance of Medical Care for Elderly People and the development of medical information databases have been pursued by the national government, and considerable attention has also been focused on researches conducted through the secondary uses of publicly collected data. Aside from these trends, there are numerous projects which collect diagnosis procedure combination (DPC) data to build large-scale databases for research purposes. Following to the ethics guidelines for epidemiologic studies, they collect and analyze anonymized DPC data from cooperating institutions. This communication concentrates on the use of DPC data, and outlines the scale of data currently available for research use. Examples on the use of DPC data will be shown for analysis on the current status of clinical practice from the microscopic perspective and macroscopic analysis of community medical care provision. Additionally, potential for extending studies to long-term outcomes research, limitations and issues related to the use of medical big data will also be discussed.
信息计算机化和技术发展的进步减轻了处理大量信息的限制。这导致了对使用大规模数据库(即所谓的“大数据”)的期望不断增长。医疗保健领域也是如此。国家政府一直在推行一些项目,包括根据《老年人医疗保障法》建立医疗费用账单(收据)信息和特殊健康检查信息的国家收据数据库(NDB),以及开发医疗信息数据库,同时,通过对公开收集的数据进行二次使用开展的研究也受到了相当大的关注。除了这些趋势外,还有许多项目收集诊断程序组合(DPC)数据以建立大规模数据库用于研究目的。按照流行病学研究的伦理准则,它们从合作机构收集并分析匿名的DPC数据。本交流主要关注DPC数据的使用,并概述了目前可用于研究的DPC数据规模。将展示DPC数据的使用示例,以便从微观角度分析临床实践现状,并对社区医疗服务进行宏观分析。此外,还将讨论将研究扩展到长期结局研究的潜力、与医疗大数据使用相关的局限性和问题。