Feltelius Nils, Gedeborg Rolf, Holm Lennart, Zethelius Björn
a Swedish Medical Products Agency , Uppsala , Sweden.
Ups J Med Sci. 2017 Jun;122(2):136-147. doi: 10.1080/03009734.2017.1285837. Epub 2017 Mar 3.
The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making.
A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance.
The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials.
Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.
本研究旨在描述瑞典一些与监管决策相关的医疗保健质量登记处(QRs)的内容和程序。
组织了一次研讨会,七家瑞典质量登记处参与其中,随后这些登记处回答了一份关于药物治疗和结果登记内容的问卷。介绍了患者群体、覆盖范围、数据处理和质量控制,以及法律和伦理方面的内容。质量登记处的科学出版物被用作质量和科学相关性的补充衡量标准。
所研究的登记处收集了与监管机构和卫生技术机构高度相关的临床数据。七家登记处中有五家提供了有关感兴趣药物的信息。在应用外部质量标准时,我们发现满足程度较高,尽管关于药物治疗的信息不足以回答所有监管关注的问题。一个显著的优势是可以与处方药登记处以及教育和社会经济地位信息建立联系。住院期间使用药物的数据也有一定程度的收集。收集的结果指标与相关临床试验中使用的指标相似。所有登记处都收集了患者报告的结果指标。登记处的出版物数量可观,有设计恰当的研究,包括随机登记试验。
质量登记处可能为药物有效性、安全性和成本效益提供有价值的上市后数据来源。登记处与监管机构之间加强合作以提高登记数据的质量和实用性,可能对监管效用和医疗保健提供者的价值都有益处。