Development and validation of a claims-based algorithm to identify incidents and determine the progression phases of gastric cancer cases in Japan.

IF 6.9 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology Pub Date : 2024-11-26 DOI:10.1007/s00535-024-02167-y
Takahiro Inoue, Nobukazu Agatsuma, Takahiro Utsumi, Yukari Tanaka, Yoshitaka Nishikawa, Takahiro Horimatsu, Takahiro Shimizu, Mitsuhiro Nikaido, Yuki Nakanishi, Nobuaki Hoshino, Yoshimitsu Takahashi, Takeo Nakayama, Hiroshi Seno
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Abstract

Background: Although health insurance claims data can address questions that clinical trials cannot answer, the uncertainty of disease names and the absence of stage information hinder their use in gastric cancer (GC) research. This study aimed to develop and validate a claims-based algorithm to identify and determine the progression phases of incident GC cases in Japan.

Methods: The gold standard for validation in this retrospective observational study was medical records of patients with incident GC who underwent specific treatments, defined by the claim codes associated with GC treatment. The algorithm was developed and refined using a cohort from two large tertiary care medical centers (April-September 2017 and April-September 2019) and subsequently validated using two independent cohorts: one from different periods (October 2017-March 2019 and October 2019-March 2021) and the other from a different institution (a community hospital). The algorithm identified incident cases based on a combination of the International Classification of Diseases, 10th Revision diagnosis codes for GC (C160-169), and claim codes for specific treatments, classifying them into endoscopic, surgical, and palliative groups. Positive predictive value (PPV), sensitivity of incident case identification, and diagnostic accuracy of progression phase determination were evaluated.

Results: The developed algorithm achieved PPVs of 90.0% (1119/1244) and 95.9% (94/98), sensitivities of 98.0% (1119/1142) and 98.9% (94/95) for incident case identification, with diagnostic accuracies of 94.1% (1053/1119) and 93.6% (88/94) for progression phase determination in the two validation cohorts, respectively.

Conclusions: This validated claims-based algorithm could advance real-world GC research and assist in decision-making regarding GC treatment.

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开发和验证基于索赔的算法,以确定日本胃癌病例的发病情况和发展阶段。
背景:尽管健康保险索赔数据可以解决临床试验无法回答的问题,但疾病名称的不确定性和阶段信息的缺失阻碍了其在胃癌(GC)研究中的应用。本研究旨在开发和验证一种基于索赔的算法,以识别和确定日本胃癌病例的进展阶段:在这项回顾性观察研究中,验证的金标准是接受了特定治疗的GC事件患者的医疗记录,这些医疗记录由与GC治疗相关的索赔代码定义。该算法是通过两个大型三级医疗中心的队列(2017 年 4 月至 9 月和 2019 年 4 月至 9 月)开发和完善的,随后通过两个独立队列进行了验证:一个来自不同时期(2017 年 10 月至 2019 年 3 月和 2019 年 10 月至 2021 年 3 月),另一个来自不同机构(社区医院)。该算法根据《国际疾病分类》第 10 次修订版的 GC 诊断代码(C160-169)和特定治疗的索赔代码组合确定了事件病例,并将其分为内窥镜组、手术组和姑息组。对阳性预测值(PPV)、事件病例识别的灵敏度和进展阶段判断的诊断准确性进行了评估:在两个验证队列中,所开发算法的阳性预测值分别为 90.0%(1119/1244)和 95.9%(94/98),病例识别灵敏度分别为 98.0%(1119/1142)和 98.9%(94/95),进展期判断诊断准确率分别为 94.1%(1053/1119)和 93.6%(88/94):这一经过验证的基于索赔的算法可推动现实世界中的 GC 研究,并有助于做出 GC 治疗决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Gastroenterology
Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
12.20
自引率
1.60%
发文量
99
审稿时长
4-8 weeks
期刊介绍: The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.
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