Individual mortality information in the German Pharmacoepidemiological Research Database (GePaRD): a validation study using a record linkage with a large cancer registry

Abstract

ObjectiveClaims data need to be validated to assess their use for epidemiological research. This study aimed to examine the validity of mortality information in the German Pharmacoepidemiological Research Database (GePaRD).DesignValidation study, secondary data, medical claims.SettingClaims data of two German nationwide acting statutory health insurance providers (SHIs) contributing data for GePaRD; record linkage with epidemiological cancer registry providing individual official mortality information.ParticipantsAll women insured with the two SHIs whose insurance coverage ended in the period 2006–2013 and who were residents of North Rhine Westphalia.MeasuresDescriptive statistics were used to analyse the performance of the linkage procedure. Further, we calculated measures of agreement between the official and the GePaRD-based vital status and assessed differences between the official and the GePaRD-based date of death.ResultsOf the 256 111 women of the linkage sample, 25 528 were classified as ‘deceased’ in GePaRD and the others as ‘alive’. Compared with the official data, the GePaRD-based vital status showed a sensitivity of 95.9% and a specificity of 99.4%. The negative predictive value was 99.6% and the positive predictive value 94.3%. The date of death agreed in 96.3% between both data sources.ConclusionsThe vital status recorded in GePaRD was of high accuracy and discrepancies between dates of death in GePaRD and official dates were rare. This underlines the potential of the database for conducting large cohort studies with mortality as the endpoint.

A health insurance claims analysis on the effect of female sex on long-term outcomes after peripheral endovascular interventions for symptomatic peripheral arterial occlusive disease

“…The BARMER cohort included nationally generalizable data with a sex and age distribution comparable to that in Western European Countries and has been widely used for cardiovascular research. [21][22][23][24] A regular random sample validation of internal and external validity is performed by the Medical Service of the Health Funds in Germany, and various peerreviewed validation studies have been previously reported. [21][22][23][24] We used the International Classification of Diseases, 10th revision, in its German modification (ICD-10-GM) to identify the diagnosis and the Operations and Procedures Codes to identify the procedures.…”

“…[21][22][23][24] A regular random sample validation of internal and external validity is performed by the Medical Service of the Health Funds in Germany, and various peerreviewed validation studies have been previously reported. [21][22][23][24] We used the International Classification of Diseases, 10th revision, in its German modification (ICD-10-GM) to identify the diagnosis and the Operations and Procedures Codes to identify the procedures. The German Operations and Procedures Codes are adapted to the International Classification of Procedures in Medicine.…”

Rationale and design of a European epidemiological post-authorization safety study (PASS) program: rivaroxaban use in routine clinical practice

“…Table S1). Database-specific strategies are used for ascertainment of allcause mortality, including Read codes, patient registration status or death information recorded in THIN, record of the date of death in the PHARMO Database Network, death recorded as the reason for hospital discharge or termination of insurance in GePaRD [23], and death recorded in the Cause of Death Register for Sweden. To validate outcomes in THIN, anonymized patient profiles, including any free-text comments related to the event, are manually reviewed.…”

Quality of care in surgical/interventional vascular medicine: what can routinely collected data from the insurance companies achieve?

“…In addition to random sampling and additional needs-based reviews by the medical service of German statutory health insurance providers (Medizinischer Dienst der Krankenversicherung [MDK]), scientifically initiated validation studies with routinely collected data sources are available in Germany, for example, on mortality in the German pharmacoepidemiological research database (GePaRD) with high sensitivity (95.9%) and specificity (99.4%) [33] and on diagnoses (sensitivity to dementia 80%, heart failure 97% and tuberculosis 100%) [45]; however, outpatient diagnoses can have significantly lower sensitivity rates, which is attributed to the (quarterly) coding practices in Germany (sensitivity to tuberculosis 40%) [45].…”