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Studies using real-world data are recently increasing worldwide. Various types of real-world data are available in Japan. Administrative claims databases include the National Database (NDB) and other types of databases including several commercially available databases. This article describes the DeSC database, newly constructed by DeSC Healthcare Co., Ltd. in 2020. One of the features of the DeSC database is that it includes data from the National Health Insurance, Health Insurance, and Advanced Elderly Medical Service System. In the present article, we referred to our previous study on population representativeness of the DeSC database and explained its overview. Estimated prevalence of some diseases were described for each type of insurance. Furthermore, we discussed the use of the DeSC database for clinical epidemiology and pharmacoepidemiology research.
RESUMO
Medical claims database is an important source of data for studying the characteristics, and burden of diseases, to provide a basis for the development of policy on management. The database is usually used to identify patients through International Classification of Diseases and free text-building algorithms, thus it is crucial to validate whether the algorithm is correctly identifing the targeted population. This paper introduces both traditional and emerging validation methods including machine learning, natural language processing and database linkage etc.. We also have tried to present a suitable validation method for the current situation in China, so as to promote the application of big data in medical areas and to provide reference for epidemiology studies, based on medical claims database in this country.
RESUMO
<b>Introduction</b> : The appropriate size of the regional coverage area for primary care in Japan has been unclear. The aim of this study was to determine the geographical distribution of primary care clinics for elderly ambulatory diabetic patients.<br><b>Methods</b> : Using an insurance claims database, we extracted data of patients aged 75 years and older requiring ambulatory diabetic care in May 2010 in Ibaraki prefecture. The geographical distance from each municipal office to the clinics was analyzed.<br><b>Results</b> : A total of 17,717 data points were extracted from the database. Data points that could not be mapped due to coding errors were eliminated, resulting in 17,144 (96.8%) data points that were ultimately analyzed. The median [25th-75th percentile] geographical distance was 5.5 [2.3-9.9] km. The distance was not related to municipal population, aging rate, or area size.<br><b>Conclusion</b> : The coverage area for diabetic care in this primary care setting was estimated. For most elderly ambulatory diabetic patients, clinics are distributed within a 10-km radius area. Further investigation is needed to clarify primary care coverage areas that result in the most efficient use of medical resources.
RESUMO
Application of a Japanese insurance claims database to pharmacovigilance activities in pharmaceutical industry was discussed. Using a commercially available insurance claims database, incidences of several cancers, the number of patients who were administered anticancer agents, and possible adverse effects were studied. Cancer incidences obtained from the database were virtually equivalent to those from a traditional survey program. The number of cancer patients included in the database with one million beneficiaries, were a few thousands a year. Disorders in epithelial-derived tissue were observed more frequently in lung cancer patients after the initiation of EGF tyrosine kinase inhibitor therapy than after platinum-based therapy, suggesting possible candidates of adverse effects of the EGF tyrosine kinase. We concluded that an estimation of disease incidence and selecting candidates of adverse events with the claims database is theoretically possible. And the database is also applicable to pharmacovigilance fields. (Jpn J Pharmacoepidemiol 2012; 17(2): 145-153)