Egashira Shuhei, Imanaka Yuichi
Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University.
J Atheroscler Thromb. 2024 Oct 1;31(10):1341-1352. doi: 10.5551/jat.RV22022. Epub 2024 Aug 3.
Although administrative claims databases have recently been used for clinical research in Japan, no detailed description of their utilization in stroke research is available. We reviewed stroke studies using the Diagnosis Procedure Combination (DPC), the National Database of Health Insurance Claims and Specific Health Checkups (NDB), and several commercial databases sourced from social health insurance associations, focusing on their applications and limitations.
Original articles on stroke published by April 2024 using the DPC, NDB, and commercial databases were identified in Ovid MEDLINE. The characteristics of each database were compared in terms of comprehensiveness, traceability, baseline information, and outcome assessment in stroke research.
A total of 114 studies were included (83 for DPC, 6 for NDB, and 25 for commercial databases). The number of stroke studies using administrative databases in Japan is still approximately 10 per year, although there is a slowly increasing trend. The DPC database was utilized for short-term outcome studies because of its detailed baseline and outcome information, although the inability to track patients once they changed facilities limits their use in long-term studies. The NDB database is potentially useful for long-term studies because of its comprehensiveness and traceability, but difficulties in data access restrict its usage. The most commonly used commercial database utilizes baseline information on lifestyle and blood test data, although the lack of coverage for those over 75 years old may limit its generalizability.
Administrative claims databases are beginning to be used in stroke research in Japan but are not yet fully utilized. Researchers need to understand their applications and limitations.
尽管行政索赔数据库最近在日本被用于临床研究，但尚无关于其在中风研究中应用的详细描述。我们回顾了使用诊断程序组合（DPC）、全国健康保险索赔和特定健康检查数据库（NDB）以及几个来自社会健康保险协会的商业数据库进行的中风研究，重点关注其应用和局限性。
在Ovid MEDLINE中检索截至2024年4月发表的使用DPC、NDB和商业数据库的中风原始文章。比较了每个数据库在中风研究中的全面性、可追溯性、基线信息和结局评估方面的特点。
共纳入114项研究（DPC相关研究83项，NDB相关研究6项，商业数据库相关研究25项）。日本使用行政数据库的中风研究数量每年仍约为10项，不过呈缓慢上升趋势。DPC数据库因其详细的基线和结局信息而被用于短期结局研究，但其一旦患者更换医疗机构就无法追踪，这限制了其在长期研究中的应用。NDB数据库因其全面性和可追溯性对长期研究可能有用，但数据获取困难限制了其使用。最常用的商业数据库利用生活方式基线信息和血液检测数据，不过75岁以上人群覆盖不足可能会限制其普遍性。
行政索赔数据库在日本的中风研究中已开始使用，但尚未得到充分利用。研究人员需要了解其应用和局限性。
