To evaluate the efficacy of the claims’-based definition of age-related macular degeneration (AMD) in detecting clinically-diagnosed AMD.
A validation study using cross-sectional data.
Seven hundred clinically-diagnosed AMD patients and seven hundred non-AMD individuals were randomly selected from patients at the Kyoto University Hospital’s ophthalmology outpatient clinic between January 2011 and December 2017. We evaluated the sensitivity, specificity, and positive/negative likelihood ratio of eight different claims’-based definitions of AMD for detecting clinically-diagnosed AMD. These definitions consist of the diagnosis name (AMD) in combination with (1) fluorescent fundus angiography, and/or (2) treatment of AMD, and (3) the exclusion of patients who had a diagnosis of central serous chorioretinopathy (CSC) or myopic choroidal neovascularization.
Defining by the diagnosis name AMD in the claims’ data showed the highest accuracy (sensitivity 94.9%, specificity 92.6%, accuracy 93.7%). Combining the diagnosis name AMD with fluorescence fundus angiography and/or anti-vascular endothelial growth factor (anti VEGF) treatment increased the specificity at the expense of sensitivity. Notably, the combination with AMD treatment achieved a specificity of 98.3%.
The current validation study elucidated the high accuracy of the disease name (AMD) in the claims’ data for identifying clinically-diagnosed AMD at a single university hospital. Although drawing wider conclusions may be limited, the results of this study contribute to creating real-world evidence in ophthalmology, based on the National Database of Health Insurance Claims in Japan.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Kawasaki R, Wang JJ, Ji GJ, Taylor B, Oizumi T, Daimon M, et al. Prevalence and risk factors for age-related macular degeneration in an adult Japanese population: the Funagata study. Ophthalmology. 2008; 115:1376–81, 81 e1–2.
Kawasaki R, Yasuda M, Song SJ, Chen SJ, Jonas JB, Wang JJ, et al. The prevalence of age-related macular degeneration in Asians: a systematic review and meta-analysis. Ophthalmology. 2010;117:921–7.
Varma R, Fraser-Bell S, Tan S, Klein R, Azen SP, Los Angeles Latino Eye Study G. Prevalence of age-related macular degeneration in Latinos: the Los Angeles Latino eye study. Ophthalmology. 2004; 111:1288–97.
Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study Ophthalmol. 1992;99:933–43.
Vingerling JR, Dielemans I, Hofman A, Grobbee DE, Hijmering M, Kramer CF, et al. The prevalence of age-related maculopathy in the Rotterdam Study. Ophthalmology. 1995;102:205–10.
Mitchell P, Smith W, Attebo K, Wang JJ. Prevalence of age-related maculopathy in Australia. Blue Mount Eye Study Ophthalmol. 1995;102:1450–60.
Nakata I, Yamashiro K, Nakanishi H, Akagi-Kurashige Y, Miyake M, Tsujikawa A, et al. Prevalence and characteristics of age-related macular degeneration in the Japanese population: the Nagahama study. Am J Ophthalmol. 2013;156(1002–9):e2.
Ikegami N, Yoo BK, Hashimoto H, Matsumoto M, Ogata H, Babazono A, et al. Japanese universal health coverage: evolution, achievements, and challenges. Lancet. 2011;378:1106–15.
Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009;24:63–71.
Wu TY, Majeed A, Kuo KN. An overview of the healthcare system in Taiwan. Lond J Prim Care (Abingdon). 2010;3:115–9.
Park SJ, Kwon KE, Choi NK, Park KH, Woo SJ. Prevalence and incidence of exudative age-related macular degeneration in South Korea: a nationwide population-based study. Ophthalmology. 2015;122:2063–70.
Kubo S, Noda T, Myojin T, Yuichi N, Higashino T, Matsui H, et al. National database of health insurance claims and specific health checkups of Japan (NDB): outline and patient-matching technique. bioRxiv. 2018. https://doi.org/10.1101/280008.
Kato G. History of the secondary use of national database of health insurance claims and specific health checkups of Japan (NDB). Trans Jpn Soc Med Biol Eng. 2017;55:143–50.
Cheng CL, Lee CH, Chen PS, Li YH, Lin SJ, Yang YH. Validation of acute myocardial infarction cases in the national health insurance research database in taiwan. J Epidemiol. 2014;24:500–7.
Kern DM, Davis J, Williams SA, Tunceli O, Wu B, Hollis S, et al. Validation of an administrative claims’s-based diagnostic code for pneumonia in a US-based commercially insured COPD population. Int J Chron Obstruct Pulmon Dis. 2015;10:1417–25.
Ando T, Ooba N, Mochizuki M, Koide D, Kimura K, Lee SL, et al. Positive predictive value of ICD-10 codes for acute myocardial infarction in Japan: a validation study at a single center. BMC Health Serv Res. 2018;18:895.
Hosoda Y, Miyake M, Schellevis RL, Boon CJF, Hoyng CB, Miki A, et al. Genome-wide association analyses identify two susceptibility loci for pachychoroid disease central serous chorioretinopathy. Commun Biol. 2019;2:468.
Hosoda Y, Yoshikawa M, Miyake M, Tabara Y, Ahn J, Woo SJ, et al. CFH and VIPR2 as susceptibility loci in choroidal thickness and pachychoroid disease central serous chorioretinopathy. Proc Natl Acad Sci USA. 2018;115:6261–6.
Miyake M, Ooto S, Yamashiro K, Takahashi A, Yoshikawa M, Akagi-Kurashige Y, et al. Pachychoroid neovasculopathy and age-related macular degeneration. Sci Rep. 2015;5:16204.
Miyake M, Tsujikawa A, Yamashiro K, Ooto S, Oishi A, Tamura H, et al. Choroidal neovascularization in eyes with choroidal vascular hyperpermeability. Invest Ophthalmol Vis Sci. 2014;55:3223–30.
Miyake M, Yamashiro K, Akagi-Kurashige Y, Kumagai K, Nakata I, Nakanishi H, et al. Vascular endothelial growth factor gene and the response to anti-vascular endothelial growth factor treatment for choroidal neovascularization in high myopia. Ophthalmology. 2014;121:225–33.
Conflicts of interest
R. Tamiya, None; M. Miyake, Consultant fee, Lecture fee (Santen, Nevakar, Novartis, Alcon, HOYA, Kowa, Senju, Ellex, Johnson & Johnson, AMO); A. Kido, None; S. Hiragi, None; H. Tamura, Grant (Findex), Lecture fee, Non-financial support (Novartis), Non-financial support (Bayer, Santen); T. Kuroda, None; A. Tsujikawa, Grant, Consultant fee, Lecture fee (Canon, AMO, Wakamoto, Otsuka), Grant (Findex, Kowa, Pfizer, TOMEY, Taiho), Grant, Advisory Board fee (Santen, Senju, Alcon), Advisory Board fee (HOYA, Bayer, Novartis, Chugai, Astellas, Eisai, Daiich-Sankyo, Janssen, Kyoto Drug Discovery & Development, Allergan), Consultant fee, Lecture fee (Sanwa Kagaku Kenkyusho, Nitten, Otsuka).
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Corresponding Author: Masahiro Miyake
Below is the link to the electronic supplementary material.
About this article
Cite this article
Tamiya, R., Miyake, M., Kido, A. et al. Validation study of the claims-based definition for age-related macular degeneration at a single university hospital in Japan. Jpn J Ophthalmol 65, 388–394 (2021). https://doi.org/10.1007/s10384-021-00816-w
- Electronic medical record
- Claim database
- Clinical research