Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27715, USA.
Heart Fail Clin. 2013 Jan;9(1):1-13. doi: 10.1016/j.hfc.2012.09.001. Epub 2012 Oct 24.
Existing data sources for heart failure research offer advantages and disadvantages for CER. Clinical registries collect detailed information about disease presentation, treatment, and outcomes on a large number of patients and provide the "real-world" population that is the hallmark of CER. Data are not collected longitudinally, however, and follow-up is often limited. Large administrative datasets provide the broadest population coverage with longitudinal outcomes follow-up but lack clinical detail. Linking clinical registries with other databases to assess longitudinal outcomes holds great promise. The Federal Coordinating Council for Comparative Effectiveness Research recommends further efforts on longitudinal linking of administrative or EHR-based databases, patient registries, private sector databases (particularly those with commercially insured populations that are not covered under federal and state databases), and other relevant data sources containing pharmacy, laboratory, adverse events, and mortality information. Advancing the infrastructure to provide robust, scientific data resources for patient-centered CER must remain a priority.
现有的心力衰竭研究数据资源为 CER 提供了优势和劣势。临床注册收集了大量患者的疾病表现、治疗和结果的详细信息,并提供了 CER 的标志性“真实世界”人群。然而,数据不是纵向收集的,随访通常是有限的。大型行政数据集提供了最广泛的人群覆盖范围和纵向结果随访,但缺乏临床细节。将临床登记与其他数据库联系起来以评估纵向结果具有巨大的潜力。联邦协调理事会建议进一步努力实现行政或基于电子健康记录的数据库、患者登记处、私营部门数据库(特别是那些拥有商业保险人群而不受联邦和州数据库覆盖的数据库)以及其他包含药房、实验室、不良事件和死亡率信息的相关数据源的纵向链接。为以患者为中心的 CER 提供强大的科学数据资源必须仍然是一个优先事项。