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Design of and rationale for the Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System (J-DREAMS)

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Abstract

The “Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System” is a registry of patients with diabetes in Japan. The characteristics of this registry include a clinical information input process using the template function of an electronic medical record (EMR) system [the standard diabetes management template (SDMT)], a standardized exchangeable information storage format [the Standardized Structured Medical Information eXchange 2 (SS-MIX2)], and a secure and efficient information extraction process [Multipurpose Clinical Data Repository System (MCDRS)]. Together, these characteristics enable efficient data input during routine patient consultations, efficient and exact data extraction from each facility, and the integration of data across different facilities even though these data were generated by EMR systems from different vendors. The SDMT collects clinical information including the type of diabetes, body height and weight, blood pressure, lifestyle, and comorbidities. Completing this template triggers the automatic collection of other information such as fundamental information (sex, year and month of birth, and facility), prescription information, and laboratory examination results. As the information from every routine consultation is saved with an anonymized patient ID, linked data can be used as panel data allowing longitudinal investigations. The data obtained from the registry will allow analyses, for exmaple, mortality and morbidity risk, by various characteristics or drug types and may reveal unmet needs that inform future diabetes care.

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References

  1. Masakane I, Nakai S, Ogata S, Kimata N, Hanafusa N, Hamano T. An overview of regular dialysis treatment in Japan (as of December 31, 2013). J Jpn Soc Dial Ther. 2015;48:1–32.

    Article  Google Scholar 

  2. Sone H, Tanaka S, Tanaka S, Iimuro S, Oida K, Yamasaki Y, et al. Serum level of triglycerides is a potent risk factor comparable to LDL cholesterol for coronary heart disease in Japanese patients with type 2 diabetes: subanalysis of the Japan Diabetes Complications Study (JDCS). J Clin Endocrinol Metab. 2011;96:3448–56.

    Article  CAS  PubMed  Google Scholar 

  3. Kasuga M, Ueki K, Tajima N, Noda M, Ohashi K, Noto H, et al. Report of the JDS/JCA joint committee on diabetes and cancer. Diabetol Int. 2013;4:81–96.

    Article  Google Scholar 

  4. National Institute of Health and Nutrition. Summary results of the national health and nutrition survey Japan 2012; 2014. http://www0.nih.go.jp/eiken/english/research/pdf/nhns2012.pdf. Accessed on 29 Mar 2017.

  5. 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.

    Article  PubMed  Google Scholar 

  6. Sone H, Katagiri A, Ishibashi S, Abe R, Saito Y, Murase T, et al. Effects of lifestyle modifications on patients with type 2 diabetes: the Japan Diabetes Complications Study (JDCS) study design, baseline analysis and three year-interim report. Horm Metab Res. 2002;34:509–15.

    Article  CAS  PubMed  Google Scholar 

  7. Sone H, Mizuno S, Fujii H, Yoshimura Y, Yamasaki Y, Ishibashi S, et al. Is the diagnosis of metabolic syndrome useful for predicting cardiovascular disease in Asian diabetic patients? Analysis from the Japan Diabetes Complications Study. Diabetes Care. 2005;28:1463–71.

    Article  PubMed  Google Scholar 

  8. Sone H, Tanaka S, Iimuro S, Oida K, Yamasaki Y, Oikawa S, et al. Long-term lifestyle intervention lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicenter randomised controlled trial (the Japan Diabetes Complications Study). Diabetologia. 2010;53:419–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kobayashi M, Yamazaki K, Hirao K, Oishi M, Kanatsuka A, Yamauchi M, et al. The status of diabetes control and antidiabetic drug therapy in Japan—a cross-sectional survey of 17,000 patients with diabetes mellitus (JDDM 1). Diabetes Res Clin Pract. 2006;73:198–204.

    Article  PubMed  Google Scholar 

  10. Yokoyama H, Kawai K, Kobayashi M. Microalbuminuria is common in Japanese type 2 diabetic patients A nationwide survey from the Japan Diabetes Clinical Data Management Study Group (JDDM 10). Diabetes Care. 2007;30:989–92.

    Article  CAS  PubMed  Google Scholar 

  11. Matsuba I, Saito K, Takai M, Hirao K, Sone H. Fasting insulin levels and metabolic risk factors in type 2 diabetic patients at the first visit in Japan a 10-year, nationwide, observational study (JDDM 28). Diabetes Care. 2012;35:1853–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kimura M, Nakayasu K, Ohshima Y, Fujita N, Nakashima N, Jozaki H, et al. SS-MIX: a ministry project to promote standardized healthcare information exchange. Methods Inf Med. 2011;50:131.

    Article  CAS  PubMed  Google Scholar 

  13. Japan Association for Medical Informatics. “SS-MIX2 Standardized Storage” explanation of the structure and guidelines for implementation; 2014. https://www.jami.jp/jamistd/docs/SS-MIX2/descript-implemglonSS-MIX2_V1.2.pdf. Accessed on 29 Mar 2017.

  14. Clinical Data Interchange Standards Consortium. Operational Data Model (ODM)—XML; 2017. https://www.cdisc.org/standards/foundational/odm. Accessed on 29 Mar 2017.

  15. The Japan Association for Medical Informatics, the Japan Diabetes Society, the Japanese Society of Hypertension, the Japan Atherosclerosis Society, and the Japanese Society of Nephrology. Standardized Data Item Sets for Self-management of Chronic Diseases, Determined by 5 Clinical Associations in Japan; 2014. https://www.jami.jp/english/document/JAMI_HP_4itemset20150211-2.pdf. Accessed on 29 Mar 2017.

  16. Ministry of Health, Labour and Welfare. Summary of Patient Survey, 2014. http://www.mhlw.go.jp/english/database/db-hss/ps.html. Accessed on 28 May 2017.

  17. Japan Medical Association Research Institute. Japan medical association Diabetes database of clinical Medicine (J-DOME). http://jdome.jmari.med.or.jp/index.html. Accessed on 28 May 2017.

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Acknowledgements

The J-DREAMS investigators would like to thank all physicians, faculties of medical informatics department, and their staffs at the participating institutions for their cooperation and assistance in the conduct of the study. Heartfelt thanks are also due to all patients with diabetes from all parts of Japan for their participation in the study.

J-DREAMS is a research project driven by NCGM. NCGM and the JDS established a joint committee, within which members discuss the detail of study design and analysis from a scientific perspective.

The study was supported by a Ministry of Health, Labour and Welfare grant-in-aid during Fiscal Year 2014, Japan Agency for Medical Research and Development (AMED) Practical Research Project for Life-Style-Related Diseases including Cardiovascular Diseases and Diabetes Mellitus during Fiscal Years 2015–2016, and a grant for NCGM (28A-1205) during Fiscal Years 2016–2018. The development of MCDRS and SS-MIX2 implementation is partially supported by the Center of Innovation Program from the Japan Science and Technology Agency, JST.

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Authors and Affiliations

  1. Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Takehiro Sugiyama & Mitsuru Ohsugi

  2. Department of Public Health/Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan

    Takehiro Sugiyama

  3. Department of Medical Informatics, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Kengo Miyo & Ryota Kominami

  4. Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Tetsuro Tsujimoto, Mitsuru Ohsugi, Kohjiro Ueki & Hiroshi Kajio

  5. Department of Biobank, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Ryota Kominami

  6. Department of Clinical Study and Informatics, Clinical Epidemiology Section/JCRAC Data Center, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Hiroshi Ohtsu

  7. Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan

    Kayo Waki

  8. Department of Information Technology and Management, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan

    Takashi Noguchi

  9. Department of Medical Informatics and Economics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan

    Takashi Noguchi & Kazuhiko Ohe

  10. Department of Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan

    Takashi Kadowaki

  11. National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Masato Kasuga

  12. Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Kohjiro Ueki

Authors
  1. Takehiro Sugiyama
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  2. Kengo Miyo
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  3. Tetsuro Tsujimoto
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  4. Ryota Kominami
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  5. Hiroshi Ohtsu
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  6. Mitsuru Ohsugi
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  7. Kayo Waki
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  8. Takashi Noguchi
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  9. Kazuhiko Ohe
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  10. Takashi Kadowaki
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  11. Masato Kasuga
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  12. Kohjiro Ueki
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  13. Hiroshi Kajio
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Corresponding author

Correspondence to Hiroshi Kajio.

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Conflict of interest

Kayo Waki received a clinical research grant from NTT Docomo. The other authors declare that they have no conflict of interest.

Human rights statement and informed consent

All procedures followed were in accordance with Ethical Guidelines for Medical and Health Research Involving Human Subjects of 2014 and its revision of 2017 and with the Helsinki Declaration of 1964 and later versions. Based on the ethical guidelines, an opt-out consent method was chosen. By displaying posters in hospitals or through websites, patients were informed of the objectives of the study, and permission for the investigators to collect PMR data was sought. We offered opportunity for the participants to opt out of participation in the registry by filling out the opt-out form.

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Sugiyama, T., Miyo, K., Tsujimoto, T. et al. Design of and rationale for the Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System (J-DREAMS). Diabetol Int 8, 375–382 (2017). https://doi.org/10.1007/s13340-017-0326-y

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  • DOI: https://doi.org/10.1007/s13340-017-0326-y

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