晨晰統計部落格新站（統計、SPSS、BIG DATA討論園地）

          根據成功大學呂宗學教授及其團隊針對健保資料庫所作的詳盡搜尋，目前為止（2017/11/17）已有4356 篇文章以英文的形式發表在國際期刊，其中Impact factor大於10分者高達104篇，可謂是台灣醫學領域之光。

但以診斷碼（例如ICD-9 disease code）作為收案條件或結果變項（Outcome），在投稿過程中經常會被Reviewer要求提供診斷碼的驗證數據（Validation of diagnosis）。若投稿到高排名的雜誌，甚至會質疑研究者無法提供疾病嚴重度的這一點，進而拒絕文章刊登。

筆者於PubMed搜尋健保資料庫的驗證碼研究，搜尋條件如下：

條件一：Any fields（任何一個欄位）必須出現 ‘Taiwan’

條件二之一：Title、abstract或keywords (index terms) 出現‘‘health insurance’’, ‘‘national health’’, ‘‘national insurance’’, ‘‘claims data*’’, ‘‘claim data*’’, ‘‘insurance claim*’’, ‘‘insurance data*’’, ‘‘administrative data*’’, ‘‘nationwide data*’’, ‘‘national data*’’, ‘‘NHIRD’’, ‘‘NHI’’, ‘‘BNHI’’, ‘‘population based’, ’“Registry”, “Registered”

條件二之二：Title出現‘‘population*’’或‘‘nationwide’’

條件三：Title必須出現Concordant、Concordance、Accurate、Accuracy、Validating、Validate、Validity、Validation、Consistent、Consistency

接著再以人工比對摘要與全文，最後得出有11篇驗證碼研究，不過這裡有個很大限制，就是如果是文章內文有提到驗證的數據，而摘要與標題沒有相關關鍵字，那麼筆者的搜尋條件就無法找出這些研究。

這11篇研究大致可以分成2大類，第一、針對診斷碼的驗證研究；第二、疾病嚴重度的驗證研究，羅列如下：

針對診斷碼的驗證研究，包含以下7篇

1.Cheng CL, Chien HC, Lee CH, Lin SJ, Yang YH. Validity of in-hospital mortality data among patients with acute myocardial infarction or stroke in National Health Insurance Research Database in Taiwan. International journal of cardiology 2015; 201: 96-101.

2.Cheng CL, Kao YH, Lin SJ, Lee CH, Lai ML. Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan. Pharmacoepidemiology and drug safety 2011; 20(3): 236-42.

3.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. Journal of epidemiology 2014; 24(6): 500-7.

4.Hsieh CY, Chen CH, Li CY, Lai ML. Validating the diagnosis of acute ischemic stroke in a National Health Insurance claims database. Journal of the Formosan Medical Association 2015; 114: 254-9.

5.Lin CC, Lai MS, Syu CY, Chang SC, Tseng FY. Accuracy of diabetes diagnosis in health insurance claims data in Taiwan. Journal of the Formosan Medical Association 2005; 104(3): 157-63.

6.Sung SF, Hsieh CY, Lin HJ, Chen YW, Yang YH, Li CY. Validation of algorithms to identify stroke risk factors in patients with acute ischemic stroke, transient ischemic attack, or intracerebral hemorrhage in an administrative claims database. International journal of cardiology 2016; 215: 277-82.

7.Wu CS, Lai MS, Gau SS, Wang SC, Tsai HJ. Concordance between patient self-reports and claims data on clinical diagnoses, medication use, and health system utilization in Taiwan. PloS one 2014; 9(12): e112257.

疾病嚴重度的驗證研究

1.Sung SF, Hsieh CY, Lin HJ, et al. Validity of a stroke severity index for administrative claims data research: a retrospective cohort study. BMC health services research 2016; 16(1): 509.

2.Hung L-C, Sung S-F, Hsieh C-Y, Hu Y-H, Lin H-J, Chen Y-W, et al. Validation of a novel claims-based stroke severity index in patients with intracerebral hemorrhage. Journal of epidemiology. 2017;27(1):24-9.

3.Yang CC, Chen PC, Hsu CW, Chang SL, Lee CC. Validity of the age-adjusted charlson comorbidity index on clinical outcomes for patients with nasopharyngeal cancer post radiation treatment: a 5-year nationwide cohort study. PloS one 2015; 10(1): e0117323.

4.Yang H, Chen YH, Hsieh TF, Chuang SY, Wu MJ. Prediction of Mortality in Incident Hemodialysis Patients: A Validation and Comparison of CHADS2, CHA2DS2, and CCI Scores. PloS one 2016; 11(5): e0154627.

以上即為目前為止健保資料庫發表的診斷碼之驗證研究，希望此整理能夠幫助研究者在撰寫論文時有實質幫助，若需要全文者可以來信索取（raising.02@gmail.com）。