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

Manon J. M. van Oosten; Richard M. Brohet; Susan J. J. Logtenberg; Anneke Kramer; Lambert D. Dikkeschei; Marc H. Hemmelder; Henk J. G. Bilo; Kitty J. Jager; Vianda S. Stel

doi:10.1093/ckj/sfaa167

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

Manon J. M. van Oosten^*, Richard M. Brohet, Susan J. J. Logtenberg, Anneke Kramer, Lambert D. Dikkeschei, Marc H. Hemmelder, Henk J. G. Bilo, Kitty J. Jager, Vianda S. Stel

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	1586-1593
Number of pages	8
Journal	Clinical Kidney Journal
Volume	14
Issue number	6
DOIs	https://doi.org/10.1093/ckj/sfaa167
Publication status	Published - Jun-2021

Keywords

CKD
GFR
health claims data
health claims database
validity study
OUTCOMES RESEARCH
MEDICARE CLAIMS
PRIMARY-CARE
VALIDATION
RISK
MANAGEMENT
DIALYSIS
OLDER

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van Oosten, M. J. M., Brohet, R. M., Logtenberg, S. J. J., Kramer, A., Dikkeschei, L. D., Hemmelder, M. H., Bilo, H. J. G., Jager, K. J., & Stel, V. S. (2021). The validity of Dutch health claims data for identifying patients with chronic kidney disease: a hospital-based study in the Netherlands. Clinical Kidney Journal, 14(6), 1586-1593. https://doi.org/10.1093/ckj/sfaa167

@article{220635316a5640a1b9c10925d07aab7d,

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

abstract = "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.",

keywords = "CKD, GFR, health claims data, health claims database, validity study, OUTCOMES RESEARCH, MEDICARE CLAIMS, PRIMARY-CARE, VALIDATION, RISK, MANAGEMENT, DIALYSIS, OLDER",

author = "{van Oosten}, {Manon J. M.} and Brohet, {Richard M.} and Logtenberg, {Susan J. J.} and Anneke Kramer and Dikkeschei, {Lambert D.} and Hemmelder, {Marc H.} and Bilo, {Henk J. G.} and Jager, {Kitty J.} and Stel, {Vianda S.}",

year = "2021",

month = jun,

doi = "10.1093/ckj/sfaa167",

language = "English",

volume = "14",

pages = "1586--1593",

journal = "Clinical Kidney Journal",

issn = "2048-8505",

publisher = "Oxford Univ. Press, New York",

number = "6",

}

TY - JOUR

T1 - The validity of Dutch health claims data for identifying patients with chronic kidney disease

T2 - a hospital-based study in the Netherlands

AU - van Oosten, Manon J. M.

AU - Brohet, Richard M.

AU - Logtenberg, Susan J. J.

AU - Kramer, Anneke

AU - Dikkeschei, Lambert D.

AU - Hemmelder, Marc H.

AU - Bilo, Henk J. G.

AU - Jager, Kitty J.

AU - Stel, Vianda S.

PY - 2021/6

Y1 - 2021/6

N2 - 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.

AB - 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.

KW - CKD

KW - GFR

KW - health claims data

KW - health claims database

KW - validity study

KW - OUTCOMES RESEARCH

KW - MEDICARE CLAIMS

KW - PRIMARY-CARE

KW - VALIDATION

KW - RISK

KW - MANAGEMENT

KW - DIALYSIS

KW - OLDER

U2 - 10.1093/ckj/sfaa167

DO - 10.1093/ckj/sfaa167

M3 - Article

SN - 2048-8505

VL - 14

SP - 1586

EP - 1593

JO - Clinical Kidney Journal

JF - Clinical Kidney Journal

IS - 6

ER -

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

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