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Validation study of the claims-based definition for age-related macular degeneration at a single university hospital in Japan



To evaluate the efficacy of the claims’-based definition of age-related macular degeneration (AMD) in detecting clinically-diagnosed AMD.

Study design

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.

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Corresponding author

Correspondence to Masahiro Miyake.

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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).

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Corresponding Author: Masahiro Miyake

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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).

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  • Electronic medical record
  • Claim database
  • Validation
  • Clinical research
  • NDB