Annals of Clinical Neurophysiology

  • 제24권1호
  • /
  • Pages.7-16
  • /
  • 2022
  • /
  • 2508-691X(pISSN)
  • /
  • 2508-6960(eISSN)
대한임상신경생리학회 (The Korean Society of Clinical Neurophysiology)
권호 표지
DOI QR코드

DOI QR Code

Validity of the diagnosis of diabetic microvascular complications in Korean national health insurance claim data

  • Kim, Hyung Jun (Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine) ;
  • Park, Moo-Seok (Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine) ;
  • Kim, Jee-Eun (Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine) ;
  • Song, Tae-Jin (Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine)
  • 투고 : 2021.11.06
  • 심사 : 2022.02.08
  • 발행 : 2022.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods: From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results: Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0-81.4%; specificity, 10.3-53.4%), diabetic neuropathy (PPV, 55.0-81.3%; specificity, 66.7-76.7%) and diabetic retinopathy (PPV, 77.0-96.6%; specificity, 2.2-89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions: Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

키워드

과제정보

This project was supported by a grant from the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Education (grant number 2021R1F1A1048113). This work was supported by an Ewha Womans University Research Grant awarded in 2018.

참고문헌

  1. Leon BM, Maddox TM. Diabetes and cardiovascular disease: epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes 2015;6:1246-1258. https://doi.org/10.4239/wjd.v6.i13.1246
  2. Cha SA, Yun JS, Lim TS, Hwang S, Yim EJ, Song KH, et al. Severe hypoglycemia and cardiovascular or all-cause mortality in patients with type 2 diabetes. Diabetes Metab J 2016;40:202-210. https://doi.org/10.4093/dmj.2016.40.3.202
  3. Li M, Li Y, Liu J. Metabolic syndrome with hyperglycemia and the risk of ischemic stroke. Yonsei Med J 2013;54:283-287. https://doi.org/10.3349/ymj.2013.54.2.283
  4. Schmidt AM. Diabetes mellitus and cardiovascular disease. Arterioscler Thromb Vasc Biol 2019;39:558-568. https://doi.org/10.1161/ATVBAHA.119.310961
  5. Shin SA, Kim H, Lee K, Lin V, Liu G, Shin E. Effects of diabetic case management on knowledge, self-management abilities, health behaviors, and health service utilization for diabetes in Korea. Yonsei Med J 2015;56:244-252. https://doi.org/10.3349/ymj.2015.56.1.244
  6. Faselis C, Katsimardou A, Imprialos K, Deligkaris P, Kallistratos M, Dimitriadis K. Microvascular complications of type 2 diabetes mellitus. Curr Vasc Pharmacol 2020;18:117-124. https://doi.org/10.2174/1570161117666190502103733
  7. Kim JH, Kim DJ, Jang HC, Choi SH. Epidemiology of micro- and macrovascular complications of type 2 diabetes in Korea. Diabetes Metab J 2011;35:571-577. https://doi.org/10.4093/dmj.2011.35.6.571
  8. Unnikrishnan R, Anjana RM, Mohan V. Diabetes mellitus and its complications in India. Nat Rev Endocrinol 2016;12:357-370. https://doi.org/10.1038/nrendo.2016.53
  9. Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population. Int J Cardiol 2017;236:226-231. https://doi.org/10.1016/j.ijcard.2017.02.039
  10. Chang Y, Lee JS, Lee KJ, Woo HG, Song TJ. Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study. Diabetologia 2020;63:924-933. https://doi.org/10.1007/s00125-020-05112-9
  11. Chang Y, Woo HG, Park J, Lee JS, Song TJ. Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: a nationwide population-based cohort study. Eur J Prev Cardiol 2020;27:1835-1845. https://doi.org/10.1177/2047487319886018
  12. Cha MJ, Choi EK, Han KD, Lee SR, Lim WH, Oh S, et al. Effectiveness and safety of non-vitamin K antagonist oral anticoagulants in asian patients with atrial fibrillation. Stroke 2017;48:3040-3048. https://doi.org/10.1161/STROKEAHA.117.018773
  13. Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort profile: the National Health Insurance service-national sample cohort (NHIS-NSC), south korea. Int J Epidemiol 2017;46:e15. https://doi.org/10.1093/ije/dyv319
  14. Chang Y, Woo HG, Lee JS, Song TJ. Better oral hygiene is associated with lower risk of stroke. J Periodontol 2021;92:87-94. https://doi.org/10.1002/JPER.20-0053
  15. Stevens LA, Coresh J, Feldman HI, Greene T, Lash JP, Nelson RG, et al. Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol 2007;18:2749-2757. https://doi.org/10.1681/ASN.2007020199
  16. Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019;380:2295-2306. https://doi.org/10.1056/NEJMoa1811744
  17. Kim KJ, Choi J, Bae JH, Kim KJ, Yoo HJ, Seo JA, et al. Time to reach target glycosylated hemoglobin is associated with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus: a 6-year observational study. Diabetes Metab J 2021;45:368-378. https://doi.org/10.4093/dmj.2020.0046
  18. Claus D, Mustafa C, Vogel W, Herz M, Neundorfer B. Assessment of diabetic neuropathy: definition of norm and discrimination of abnormal nerve function. Muscle Nerve 1993;16:757-768. https://doi.org/10.1002/mus.880160711
  19. Krieger SM, Reimann M, Haase R, Henkel E, Hanefeld M, Ziemssen T. Sudomotor testing of diabetes polyneuropathy. Front Neurol 2018;9:803. https://doi.org/10.3389/fneur.2018.00803
  20. Patel K, Horak H, Tiryaki E. Diabetic neuropathies. Muscle Nerve 2021;63:22-30. https://doi.org/10.1002/mus.27014
  21. Azhary H, Farooq MU, Bhanushali M, Majid A, Kassab MY. Peripheral neuropathy: differential diagnosis and management. Am Fam Physician 2010;81:887-892.
  22. Cho HC. The association between serum GGT concentration and diabetic peripheral polyneuropathy in type 2 diabetic patients. Korean Diabetes J 2010;34:111-118. https://doi.org/10.4093/kdj.2010.34.2.111
  23. Lee CK, Ha HJ, Oh SJ, Kim JW, Lee JK, Kim HS, et al. Nationwide validation study of diagnostic algorithms for inflammatory bowel disease in Korean national health insurance service database. J Gastroenterol Hepatol 2020;35:760-768. https://doi.org/10.1111/jgh.14855
  24. Kim HJ, Park MS, Shin JI, Park J, Kim DH, Jeon J, et al. Associations of heart failure with susceptibility and severe complications of COVID-19: a nationwide cohort study. J Med Virol 2022;94:1138-1145. https://doi.org/10.1002/jmv.27435
  25. Umapathi T, Er B, Koh JS, Goh YH, Chua L. Guillain-Barre syndrome decreases in Singapore during the COVID-19 pandemic. J Peripher Nerv Syst 2021;26:235-236. https://doi.org/10.1111/jns.12439
  26. Seo HJ, Oh IH, Yoon SJ. A comparison of the cancer incidence rates between the national cancer registry and insurance claims data in Korea. Asian Pac J Cancer Prev 2012;13:6163-6368. https://doi.org/10.7314/APJCP.2012.13.12.6163
  27. Lee SJ, Im JS, Choi JS. Sensitivity of medical insurance claims data using population-based cancer registry data. J Korean Soc Med Inform 2002;8:35-40. https://doi.org/10.4258/jksmi.2002.8.2.35
  28. Lee SS, Ae Kong K, Kim D, Lim YM, Yang PS, Yi JE, et al. Clinical implication of an impaired fasting glucose and prehypertension related to new onset atrial fibrillation in a healthy asian population without underlying disease: a nationwide cohort study in Korea. Eur Heart J 2017;38:2599-2607. https://doi.org/10.1093/eurheartj/ehx316
  29. Bae SO, Kang GW. A comparative study of the disease codes between Korean national health insurance claims and Korean national hospital discharge in-depth injury survey. HPM 2014;24:322-329.
  30. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther 2008;88:1254-1264. https://doi.org/10.2522/ptj.20080020
  31. Park J, Kwon S, Choi EK, Choi YJ, Lee E, Choe W, et al. Validation of diagnostic codes of major clinical outcomes in a national health insurance database. Int J Arrhythm 2019;20:5. https://doi.org/10.1186/s42444-019-0005-0
  32. Vinik AI, Nevoret ML, Casellini C. The new age of sudomotor function testing: a sensitive and specific biomarker for diagnosis, estimation of severity, monitoring progression, and regression in response to intervention. Front Endocrinol (Lausanne) 2015;6:94. https://doi.org/10.3389/fendo.2015.00094
  33. Roncal-Jimenez C, Lanaspa MA, Jensen T, Sanchez-Lozada LG, Johnson RJ. Mechanisms by which dehydration may lead to chronic kidney disease. Ann Nutr Metab 2015;66:10-13.
  34. Yang Z, Zhang Y, Chen R, Huang Y, Ji L, Sun F, et al. Simple tests to screen for diabetic peripheral neuropathy. Cochrane Database Syst Rev 2018;2018:CD010975.