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The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands

BACKGROUND: Health claims data may be an efficient and easily accessible source to study chronic kidney disease (CKD) prevalence in a nationwide population. Our aim was to study Dutch claims data for their ability to identify CKD patients in different subgroups. METHODS: From a laboratory database,...

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Autores principales: van Oosten, Manon J M, Brohet, Richard M, Logtenberg, Susan J J, Kramer, Anneke, Dikkeschei, Lambert D, Hemmelder, Marc H, Bilo, Henk J G, Jager, Kitty J, Stel, Vianda S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280937/
https://www.ncbi.nlm.nih.gov/pubmed/34276977
http://dx.doi.org/10.1093/ckj/sfaa167
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author van Oosten, Manon J M
Brohet, Richard M
Logtenberg, Susan J J
Kramer, Anneke
Dikkeschei, Lambert D
Hemmelder, Marc H
Bilo, Henk J G
Jager, Kitty J
Stel, Vianda S
author_facet van Oosten, Manon J M
Brohet, Richard M
Logtenberg, Susan J J
Kramer, Anneke
Dikkeschei, Lambert D
Hemmelder, Marc H
Bilo, Henk J G
Jager, Kitty J
Stel, Vianda S
author_sort van Oosten, Manon J M
collection PubMed
description BACKGROUND: Health claims data may be an efficient and easily accessible source to study chronic kidney disease (CKD) prevalence in a nationwide population. Our aim was to study Dutch claims data for their ability to identify CKD patients in different subgroups. METHODS: From a laboratory database, we selected 24 895 adults with at least one creatinine measurement in 2014 ordered at an outpatient clinic. Of these, 15 805 had ≥2 creatinine measurements at least 3 months apart and could be assessed for the chronicity criterion. We estimated the validity of a claim-based diagnosis of CKD and advanced CKD. The estimated glomerular filtration rate (eGFR)-based definitions for CKD (eGFR < 60 mL/min/1.73 m(2)) and advanced CKD (eGFR < 30 mL/min/1.73 m(2)) satisfying and not satisfying the chronicity criterion served as reference group. Analyses were stratified by age and sex. RESULTS: In general, sensitivity of claims data was highest in the population with the chronicity criterion as reference group. Sensitivity was higher in advanced CKD patients than in CKD patients {51% [95% confidence interval (CI) 47–56%] versus 27% [95% CI 25–28%]}. Furthermore, sensitivity was higher in young versus elderly patients. In patients with advanced CKD, sensitivity was 72% (95% CI 62–83%) for patients aged 20–59 years and 43% (95% CI 38–49%) in patients ≥75 years. The specificity of CKD and advanced CKD was ≥99%. Positive predictive values ranged from 72% to 99% and negative predictive values ranged from 40% to 100%. CONCLUSION: When using health claims data for the estimation of CKD prevalence, it is important to take into account the characteristics of the population at hand. The younger the subjects and the more advanced the stage of CKD the higher the sensitivity of such data. Understanding which patients are selected using health claims data is crucial for a correct interpretation of study results.
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spelling pubmed-82809372021-07-16 The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands van Oosten, Manon J M Brohet, Richard M Logtenberg, Susan J J Kramer, Anneke Dikkeschei, Lambert D Hemmelder, Marc H Bilo, Henk J G Jager, Kitty J Stel, Vianda S Clin Kidney J Original Articles BACKGROUND: Health claims data may be an efficient and easily accessible source to study chronic kidney disease (CKD) prevalence in a nationwide population. Our aim was to study Dutch claims data for their ability to identify CKD patients in different subgroups. METHODS: From a laboratory database, we selected 24 895 adults with at least one creatinine measurement in 2014 ordered at an outpatient clinic. Of these, 15 805 had ≥2 creatinine measurements at least 3 months apart and could be assessed for the chronicity criterion. We estimated the validity of a claim-based diagnosis of CKD and advanced CKD. The estimated glomerular filtration rate (eGFR)-based definitions for CKD (eGFR < 60 mL/min/1.73 m(2)) and advanced CKD (eGFR < 30 mL/min/1.73 m(2)) satisfying and not satisfying the chronicity criterion served as reference group. Analyses were stratified by age and sex. RESULTS: In general, sensitivity of claims data was highest in the population with the chronicity criterion as reference group. Sensitivity was higher in advanced CKD patients than in CKD patients {51% [95% confidence interval (CI) 47–56%] versus 27% [95% CI 25–28%]}. Furthermore, sensitivity was higher in young versus elderly patients. In patients with advanced CKD, sensitivity was 72% (95% CI 62–83%) for patients aged 20–59 years and 43% (95% CI 38–49%) in patients ≥75 years. The specificity of CKD and advanced CKD was ≥99%. Positive predictive values ranged from 72% to 99% and negative predictive values ranged from 40% to 100%. CONCLUSION: When using health claims data for the estimation of CKD prevalence, it is important to take into account the characteristics of the population at hand. The younger the subjects and the more advanced the stage of CKD the higher the sensitivity of such data. Understanding which patients are selected using health claims data is crucial for a correct interpretation of study results. Oxford University Press 2020-11-09 /pmc/articles/PMC8280937/ /pubmed/34276977 http://dx.doi.org/10.1093/ckj/sfaa167 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
van Oosten, Manon J M
Brohet, Richard M
Logtenberg, Susan J J
Kramer, Anneke
Dikkeschei, Lambert D
Hemmelder, Marc H
Bilo, Henk J G
Jager, Kitty J
Stel, Vianda S
The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands
title The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands
title_full The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands
title_fullStr The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands
title_full_unstemmed The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands
title_short The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands
title_sort validity of dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the netherlands
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280937/
https://www.ncbi.nlm.nih.gov/pubmed/34276977
http://dx.doi.org/10.1093/ckj/sfaa167
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