Evaluation of effectiveness and quality of medical services using an integrated database of DPC and laboratory data

• Project/Area Number: 20H03907
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: The University of Tokyo
• Principal Investigator: Yasunaga Hideo 東京大学, 大学院医学系研究科(医学部), 教授 (90361485)
• Co-Investigator(Kenkyū-buntansha): 堀口 裕正 独立行政法人国立病院機構本部(総合研究センター), 診療情報分析部, 副部長 (50401104)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥17,680,000 (Direct Cost: ¥13,600,000、Indirect Cost: ¥4,080,000); Fiscal Year 2022: ¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000); Fiscal Year 2021: ¥5,980,000 (Direct Cost: ¥4,600,000、Indirect Cost: ¥1,380,000); Fiscal Year 2020: ¥6,630,000 (Direct Cost: ¥5,100,000、Indirect Cost: ¥1,530,000)
• Keywords: リアルワールドデータ / 臨床疫学 / 医療ビッグデータ

Outline of Research at the Start

本研究では、多施設からDPC(Diagnosis Procedure Combination)データと検査値データを一元的に収集し構築したデータベースを活用し、(i)医療技術（薬剤、手術・処置、診断等）の有効性評価、(ii)急性期医療サービスの質の評価を包括的に実施する。これらにより、日常臨床のみならず医療政策に役立つエビデンスを量産することを目的とする。収集するデータは、①全国千数百病院のDPCデータ、②約40施設規模の病院のDPCデータ＋オーダーリング・システムから抽出する検査値データである。これらを用いて、従来DPCデータのみでは為しえなかったリサーチ・クエスチョンの解明も実現する。

Outline of Final Research Achievements

The DPC data consists of administrative claims data and Form 1, and includes data on approximately 7 million hospitalized patients per year from more than 1,000 facilities. The administrative claims data includes patient profiles and detailed data on drugs, procedures, and treatments. Studies using similar administrative claims data have already been conducted in Japan and overseas. However, administrative claims data alone has limitations in terms of data content and accuracy. Therefore, in this study, laboratory value data were linked to the DPC data at about 40 facilities, and the data were collected and analyzed after anonymous processing. By doing so, the study was conducted to answer research questions that cannot be addressed by administrative claims data alone.

Academic Significance and Societal Importance of the Research Achievements

DPCデータを用いた研究はすでに多数出版されている。しかしDPCデータだけではデータの内容や精度に限界がある。DPCデータに検査値データを連結させることにより、DPCデータだけでは対応できないリサーチ・クエスチョンにも答える研究が可能であり、研究の幅を広げることができる。

Research Products

• [Journal Article] Comparison of cardiovascular outcomes between SGLT2 inhibitors in diabetes mellitus (2022)
  • Author(s): Suzuki Yuta、Kaneko Hidehiro、Okada Akira、Itoh Hidetaka、Matsuoka Satoshi、Fujiu Katsuhito、Michihata Nobuaki、Jo Taisuke、Takeda Norifumi、Morita Hiroyuki、Kamiya Kentaro、Matsunaga Atsuhiko、Ako Junya、Node Koichi、Yasunaga Hideo、Komuro Issei
  • Journal Title: Cardiovascular Diabetology Volume: 21 Issue: 1
  • DOI: 10.1186/s12933-022-01508-6
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Kidney outcomes in patients with diabetes mellitus did not differ between individual sodium-glucose cotransporter-2 inhibitors (2022)
  • Author(s): Suzuki Yuta、Kaneko Hidehiro、Okada Akira、Matsuoka Satoshi、Fujiu Katsuhito、Michihata Nobuaki、Jo Taisuke、Takeda Norifumi、Morita Hiroyuki、Node Koichi、Nangaku Masaomi、Yasunaga Hideo、Komuro Issei
  • Journal Title: Kidney International Volume: 102 Issue: 5 Pages: 1147-1153
  • DOI: 10.1016/j.kint.2022.05.031
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Treatments and outcomes of generalized pustular psoriasis: A cohort of 1516 patients in a nationwide inpatient database in Japan (2022)
  • Author(s): Miyachi Hideaki、Konishi Takaaki、Kumazawa Ryosuke、Matsui Hiroki、Shimizu Sayuri、Fushimi Kiyohide、Matsue Hiroyuki、Yasunaga Hideo
  • Journal Title: Journal of the American Academy of Dermatology Volume: 86 Issue: 6 Pages: 1266-1274
  • DOI: 10.1016/j.jaad.2021.06.008
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Validity of operative information in Japanese administrative data: a chart review-based analysis of 1221 cases at a single institution (2022)
  • Author(s): Konishi Takaaki、Yoshimoto Takako、Fujiogi Michimasa、Yamana Hayato、Tanabe Masahiko、Seto Yasuyuki、Yasunaga Hideo
  • Journal Title: Surgery Today Volume: 52 Issue: 10 Pages: 1484-1490
  • DOI: 10.1007/s00595-022-02521-8
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Threshold of BMI for the Development of Hypertension among Japanese Adults (2022)
  • Author(s): Suzuki Yuta、Kaneko Hidehiro、Yano Yuichiro、Okada Akira、Hashimoto Yohei、Itoh Hidetaka、Matsuoka Satoshi、Yokota Isao、Fujiu Katsuhito、Michihata Nobuaki、Jo Taisuke、Takeda Norifumi、Morita Hiroyuki、Kamiya Kentaro、Matsunaga Atsuhiko、Ako Junya、Node Koichi、Yasunaga Hideo、Komuro Issei
  • Journal Title: The Journal of Nutrition Volume: 152 Issue: 11 Pages: 2565-2571
  • DOI: 10.1093/jn/nxac192
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Clinical Characteristics and Incidences of Benign and Malignant Insulinoma Using a National Inpatient Database in Japan (2021)
  • Author(s): Kurakawa Kayo Ikeda、Okada Akira、Manaka Katsunori、Konishi Takaaki、Jo Taisuke、Ono Sachiko、Uda Kazuaki、Michihata Nobuaki、Matsui Hiroki、Fushimi Kiyohide、Yamaguchi Satoko、Yamauchi Toshimasa、Nangaku Masaomi、Yasunaga Hideo、Kadowaki Takashi
  • Journal Title: The Journal of Clinical Endocrinology & Metabolism Volume: 106 Pages: 168-173
  • DOI: 10.1210/clinem/dgab559
  • Peer Reviewed
• [Journal Article] Potassium Concentration in Initial Fluid Therapy and In-Hospital Mortality of Patients with Diabetic Ketoacidosis (2021)
  • Author(s): Okada Akira、Yamana Hayato、Morita Kojiro、Sato Yukihito、Yamaguchi Satoko、Kurakawa Kayo Ikeda、Michihata Nobuaki、Matsui Hiroki、Fushimi Kiyohide、Nangaku Masaomi、Yamauchi Toshimasa、Yasunaga Hideo、Kadowaki Takashi
  • Journal Title: The Journal of Clinical Endocrinology & Metabolism Volume: 106 Issue: 5 Pages: e2162-e2175
  • DOI: 10.1210/clinem/dgab029
  • Peer Reviewed
• [Journal Article] Association between nutritional guidance or ophthalmological examination and discontinuation of physician visits in patients with newly diagnosed diabetes: A retrospective cohort study using a nationwide database (2021)
  • Author(s): Okada Akira、Ono Sachiko、Yamaguchi Satoko、Yamana Hayato、Ikeda Kurakawa Kayo、Michihata Nobuaki、Matsui Hiroki、Nangaku Masaomi、Yamauchi Toshimasa、Yasunaga Hideo、Kadowaki Takashi
  • Journal Title: Journal of Diabetes Investigation Volume: N/A Issue: 9 Pages: 1619-1631
  • DOI: 10.1111/jdi.13510
  • Peer Reviewed / Open Access
• [Journal Article] Association between early antibiotic treatment and clinical outcomes in children hospitalized for asthma exacerbation (2021)
  • Author(s): Okubo Yusuke、Horimukai Kenta、Michihata Nobuaki、Morita Kojiro、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
  • Journal Title: Journal of Allergy and Clinical Immunology Volume: 147 Issue: 1 Pages: 114-122.e14
  • DOI: 10.1016/j.jaci.2020.05.030
  • Peer Reviewed
• [Journal Article] Association between parenteral nutrition in the early phase and outcomes in patients with abdominal trauma undergoing emergency laparotomy: A retrospective nationwide study (2021)
  • Author(s): Otaka Shunichi、Aso Shotaro、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
  • Journal Title: Clinical Nutrition ESPEN Volume: 41 Pages: 371-376
  • DOI: 10.1016/j.clnesp.2020.10.018
  • Peer Reviewed
• [Journal Article] Associations between early parenteral nutrition and in-hospital outcomes in underweight patients with gastrointestinal surgery (2021)
  • Author(s): Otaka Shunichi、Aso Shotaro、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
  • Journal Title: Clinical Nutrition ESPEN Volume: 43 Pages: 464-470
  • DOI: 10.1016/j.clnesp.2021.03.005
  • Peer Reviewed
• [Journal Article] High-dose versus low-dose intravenous immunoglobulin for treatment of children with Kawasaki disease weighing 25 kg or more (2020)
  • Author(s): Suzuki Takanori、Michihata Nobuaki、Yoshikawa Tetsushi、Hata Tadayoshi、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
  • Journal Title: European Journal of Pediatrics Volume: 179 Issue: 12 Pages: 1901-1907
  • DOI: 10.1007/s00431-020-03794-2
  • Peer Reviewed
• [Journal Article] Stent as a bridge to surgery or immediate colectomy for malignant right colonic obstruction: propensity-scored, national database study (2020)
  • Author(s): Sakamoto T、Fujiogi M、Lefor A K、Matsui H、Fushimi K、Yasunaga H
  • Journal Title: British Journal of Surgery Volume: 107 Issue: 10 Pages: 1354-1362
  • DOI: 10.1002/bjs.11561
  • Peer Reviewed
• [Journal Article] Early Versus Late Rib Fixation in Patients With Traumatic Rib Fractures: A Nationwide Study (2020)
  • Author(s): Otaka Shunichi、Aso Shotaro、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
  • Journal Title: The Annals of Thoracic Surgery Volume: 110 Issue: 3 Pages: 988-992
  • DOI: 10.1016/j.athoracsur.2020.03.084
  • Peer Reviewed
• [Journal Article] Stress ulcer prophylaxis plus enteral nutrition versus enteral nutrition alone in critically ill patients at risk for gastrointestinal bleeding: a propensity-matched analysis (2020)
  • Author(s): Ohbe Hiroyuki、Morita Kojiro、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
  • Journal Title: Intensive Care Medicine Volume: 46 Issue: 10 Pages: 1948-1949
  • DOI: 10.1007/s00134-020-06136-w
  • Peer Reviewed