ArticleBMC musculoskeletal disorders2021
The validity of the claims-based definition of rheumatoid arthritis evaluated in 64 hospitals in Japan.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Accuracy of Diagnostic Codes and Algorithms Used to Identify Rheumatoid Arthritis and Juvenile Idiopathic Arthritis in Administrative Claims and Electronic Health Records: Systematic Review and Meta-Analysis.Arthritis care & research · 2026Pooled it
- Financial reimbursement incentives in the use of biosimilars for rheumatoid arthritis in Japan.Journal of pharmaceutical policy and practice · 2026Article
- Trends in the use of validated claims-based algorithms in Japanese post-marketing database studies.Frontiers in pharmacology · 2025Article
- A novel method to monitor rheumatoid arthritis prevalence using hospital and medication databases.Arthritis research & therapy · 2024Article
- Article
- Association of Hyperkalemia and Hypokalemia with Patient Characteristics and Clinical Outcomes in Japanese Hemodialysis (HD) Patients.Journal of clinical medicine · 2023Article
- Unincreased risk of hospitalized infection under targeted therapies versus methotrexate in elderly patients with rheumatoid arthritis: a retrospective cohort study.Arthritis research & therapy · 2022Article
- Validity of diagnoses, procedures, and birth records in a Japanese administrative claims database for pediatric patients.Pediatrics international : official journal of the Japan Pediatric SocietyArticle
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn administrative database covering a whole population such as the national database in Japan may be used to estimate the nationwide prevalence of diseases including rheumatoid arthritis (RA) when a well-validated definition of the disease is available. In Japan, the record linkage between the administrative database and medical charts in hospitals is strictly prohibited. A "hospital-based" validation study is one of few possible validation studies where claims kept inside the study hospital are rearranged into the database structure.
methodsWe selected random samples of 19,734 patients from approximately 1.6 million patients who received medical care between February 2018 and January 2019 in one of the 64 hospitals of the Tokushukai Medical Group. We excluded patients whose observation period was less than 365 days and identified 334 patients who met the definition of "possible cases of RA" whose medical charts were then independently evaluated by two rheumatologists. In a sensitivity analysis, we assessed bias due to misclassifying some patients with RA who did not meet the definition of "possible cases of RA" as a patient with no RA.
resultsThe kappa coefficient between the two rheumatologists was 0.80. The prevalence of RA in the study population was estimated to be 0.56%. We found that [condition code of RA] and ([any disease-modifying antirheumatic drug] or [oral corticosteroid with no systemic autoimmune diseases (other than RA) and no polymyalgia rheumatica]) had a relatively high sensitivity (approximately 73%) and a high positive predictive value (approximately 80%). In a sensitivity analysis, we found that when some patients with RA who did not meet the definition of "possible cases of RA" were misclassified as a patient with no RA, then this would lead to underestimation of the prevalence of the definition-positive patients and the adjusted prevalence.
conclusionsWe recommend using the claims-based definition of RA (found in the current validation study) to estimate the prevalence of RA in Japan. We also suggest estimating the adjusted prevalence using the quantitative bias analysis method, since the prevalence of the disease in the "hospital-based" validation study is different from that in the administrative database.
trial registrationThe current study is not a clinical trial and hence not subject to trial registration.
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