Ray W A, Griffin M R
Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232.
Am J Epidemiol. 1989 Apr;129(4):837-49. doi: 10.1093/oxfordjournals.aje.a115198.
Because of the high prevalence of prescription drug use and the incomplete understanding of drug effects at the time of licensing, ongoing epidemiologic monitoring is required to provide information for clinical and regulatory decisions. Data produced through the administration of Medicaid programs have been considered for this purpose because the computerized files include prescription and diagnostic information for large, defined populations. However, the limited amount of data available in the computerized files and the atypical demographic characteristics of Medicaid populations create formidable difficulties in the use of these data for pharmacoepidemiology. This paper reviews these methodological problems and describes pragmatic solutions that have been developed through the ongoing use of these data bases for epidemiologic studies.
由于处方药使用的高普及率以及在药品许可时对药物效果的不完全了解，需要持续的流行病学监测来为临床和监管决策提供信息。为此，人们考虑了通过医疗补助计划产生的数据，因为计算机化文件包含了针对大型特定人群的处方和诊断信息。然而，计算机化文件中可用数据量有限，且医疗补助人群的非典型人口特征给将这些数据用于药物流行病学研究带来了巨大困难。本文回顾了这些方法学问题，并描述了通过持续使用这些数据库进行流行病学研究而开发出的实用解决方案。
