title: Mortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation study.
abstract: BACKGROUND
  Electronic healthcare databases are of increasing importance in health research and mortality is one of the most relevant outcomes. However, data in these databases need to be validated, since they are often generated for reimbursement purposes. The aims of this study were to compare mortality figures from the German Pharmacoepidemiological Research Database (GePaRD) on an aggregated level with external data from the Federal Statistical Office of Germany (FSOG) and to assess consistency of records of death from core data and hospital data within GePaRD.
  
  
  METHODS
  The study population comprised insurants of four statutory health insurances providing data for GePaRD with either continuous insurance coverage from January 1(st) to December 31(st) 2006 or until death. The sex-specific mortality rate, stratified and standardized by age, and the percentage of hospital deaths among all deaths was compared with data from the FSOG. Furthermore, the agreement between the dates of death according to hospital data and core data was assessed within GePaRD.
  
  
  RESULTS
  The study population comprised 12,033,622 insurants. Compared to FSOG data, the age-standardised mortality rate in GePaRD was 21% and 29% lower in women and men, respectively. Regional analyses also indicated lower mortality rates in all federal states except for Bremen, where the age-standardised mortality rate was similar to FSOG data for both sexes. The percentage of hospital deaths among all deaths corresponded well with external data. The proportion of inpatient deaths also recorded in the health insurance core data was 98.5%. Furthermore, 94% of dates of death documented in hospital agreed with the dates of death according to the health insurance core data.
  
  
  CONCLUSIONS
  The lower mortality rates in almost all federal states might result from the higher socioeconomic status of the GePaRD study population compared to the overall population in Germany. In the federal state of Bremen, where socioeconomic representativeness is higher due to additional inclusion of two local health insurances, the mortality rates were in good accordance with external data. Agreement of the percentage of hospital deaths among all deaths between GePaRD and national statistics suggested completeness of outpatient mortality information.
authors.affiliation: Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. ohlmeier@bips.uni-bremen.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ohlmeier
authors.affiliation: Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. langner@bips.uni-bremen.de.
authors.forename: Ingo
authors.initials: I
authors.lastname: Langner
authors.affiliation: Hubertus Wald Tumor Center - University Cancer Center Hamburg (UCCH)/University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany. k.hillebrand@uke.de.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Hillebrand
authors.affiliation: Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. schmedt@bips.uni-bremen.de.
authors.forename: Niklas
authors.initials: N
authors.lastname: Schmedt
authors.affiliation: Helmholtz Centre for Infection Research, Inhoffestr. 7, 38124, Braunschweig, Germany. Rafael.Mikolajczyk@helmholtz-hzi.de.|Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Rafael.Mikolajczyk@helmholtz-hzi.de.
authors.forename: Rafael
authors.initials: R
authors.lastname: Mikolajczyk
authors.affiliation: Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. riedel@bips.uni-bremen.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Riedel
authors.affiliation: Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. garbe@uni-bremen.de.|Core Scientific Area 'Health Sciences' at the University of Bremen, Grazer Str. 2, 28334, Bremen, Germany. garbe@uni-bremen.de.|Department of Human and Health Sciences, University of Bremen, Grazer Str. 2, 28334, Bremen, Germany. garbe@uni-bremen.de.
authors.forename: Edeltraut
authors.initials: E
authors.lastname: Garbe
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000067470:Cellular Reprogramming Techniques; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000592:standards*; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D017891:Pharmacoepidemiology / Q000379:methods* / Q000592:standards*; D012107:Research Design; D017678:Sex Distribution; D012959:Socioeconomic Factors; D055815:Young Adult