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Validity of Diagnostic Algorithms for Cardiovascular Diseases in Japanese Health Insurance Claims
Koshiro Kanaoka1,2, Yoshitaka Iwanaga1, Katsuki Okada3,4
1Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Insights
A new algorithm accurately identifies hospitalized patients with major cardiovascular diseases using Japanese health insurance claims. This method is valid for future nationwide administrative data studies on cardiovascular disease.
Area of Science:
- Cardiovascular Medicine
- Health Informatics
- Epidemiology
Background:
- Accurate identification of hospitalized patients with acute major cardiovascular diseases (CVDs) is crucial for epidemiological research and healthcare management.
- Health insurance claims data offer a potential resource for large-scale CVD surveillance, but require validated diagnostic algorithms.
Purpose of the Study:
- To validate a claims-based diagnostic algorithm for identifying hospitalized patients with acute coronary syndrome (ACS), acute heart failure (HF), and acute aortic disease (AAD) in Japan.
Main Methods:
- A retrospective, multicenter validation study was conducted using data from four Japanese hospitals.
- The algorithm utilized International Classification of Diseases, 10th Revision (ICD-10) codes, medical examinations, and treatments.
- Sensitivity and positive predictive values were calculated for ACS, acute HF, and AAD.
Main Results:
- The algorithm demonstrated acceptable validity for Japanese claims data.
- For ACS, sensitivity was 0.86 and positive predictive value was 0.95.
- For acute HF, sensitivity was 0.74 and positive predictive value was 0.79.
- For AAD, sensitivity was 0.86 and positive predictive value was 0.83.
Conclusions:
- The developed claims-based diagnostic algorithm is a valid tool for identifying hospitalized patients with major CVDs in Japan.
- This validated algorithm provides a foundation for future research utilizing nationwide administrative data on cardiovascular diseases.
Background:
We aimed to validate a claims-based diagnostic algorithm to identify hospitalized patients with acute major cardiovascular diseases (CVDs) from health insurance claims in Japan.
Methods And Results:
This retrospective multicenter validation study was conducted at 4 institutes, including Japanese Circulation Society-certified and uncertified hospitals in Japan. Data on patients with CVDs in departmental lists or with International Classification of Diseases, 10th Revision (ICD-10) codes for CVDs hospitalized between April 2018 and March 2019 were extracted. We examined the sensitivity and positive predictive value of a diagnostic algorithm using ICD-10 codes, medical examinations, and treatments for acute coronary syndrome (ACS), acute heart failure (HF), and acute aortic disease (AAD). We identified 409 patients with ACS (mean age 70.6 years; 24.7% female), 615 patients with acute HF (mean age 77.3 years; 46.2% female), and 122 patients with AAD (mean age 73.4 years; 36.1% female). The respective sensitivity and positive predictive value for the algorithm were 0.86 (95% confidence interval [CI] 0.82-0.89) and 0.95 (95% CI 0.92-0.97) for ACS; 0.74 (95% CI 0.70-0.77) and 0.79 (95% CI 0.76-0.83) for acute HF; and 0.86 (95% CI 0.79-0.92) and 0.83 (95% CI 0.76-0.89) for AAD.
Conclusions:
The validity of the diagnostic algorithm for Japanese claims data was acceptable. Our results serve as a foundation for future studies on CVDs using nationwide administrative data.
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