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评估电子医疗数据库在中国药品上市后安全监测和药物流行病学中的应用。

Evaluation of Electronic Healthcare Databases for Post-Marketing Drug Safety Surveillance and Pharmacoepidemiology in China.

机构信息

Department of Epidemiology and Bio-Statistics, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China.

Epidemiology, Pfizer Inc., New York, NY, USA.

出版信息

Drug Saf. 2018 Jan;41(1):125-137. doi: 10.1007/s40264-017-0589-z.

Abstract

INTRODUCTION

Electronic healthcare databases (EHDs) are used increasingly for post-marketing drug safety surveillance and pharmacoepidemiology in Europe and North America. However, few studies have examined the potential of these data sources in China.

METHODS

Three major types of EHDs in China (i.e., a regional community-based database, a national claims database, and an electronic medical records [EMR] database) were selected for evaluation. Forty core variables were derived based on the US Mini-Sentinel (MS) Common Data Model (CDM) as well as the data features in China that would be desirable to support drug safety surveillance. An email survey of these core variables and eight general questions as well as follow-up inquiries on additional variables was conducted. These 40 core variables across the three EHDs and all variables in each EHD along with those in the US MS CDM and Observational Medical Outcomes Partnership (OMOP) CDM were compared for availability and labeled based on specific standards.

RESULTS

All of the EHDs' custodians confirmed their willingness to share their databases with academic institutions after appropriate approval was obtained. The regional community-based database contained 1.19 million people in 2015 with 85% of core variables. Resampled annually nationwide, the national claims database included 5.4 million people in 2014 with 55% of core variables, and the EMR database included 3 million inpatients from 60 hospitals in 2015 with 80% of core variables. Compared with MS CDM or OMOP CDM, the proportion of variables across the three EHDs available or able to be transformed/derived from the original sources are 24-83% or 45-73%, respectively.

CONCLUSIONS

These EHDs provide potential value to post-marketing drug safety surveillance and pharmacoepidemiology in China. Future research is warranted to assess the quality and completeness of these EHDs or additional data sources in China.

摘要

简介

电子医疗数据库(EHD)在欧美被广泛应用于药品上市后安全性监测和药物流行病学研究。然而,在中国,鲜有研究对这些数据源的应用潜力进行探索。

方法

本研究选取了中国三种主要类型的 EHD(即区域性社区数据库、全国理赔数据库和电子病历数据库)进行评估。基于美国 Mini-Sentinel(MS)通用数据模型(CDM)以及中国数据特点,共衍生出 40 个核心变量,这些变量对于支持药物安全性监测是有必要的。我们对这些核心变量和 8 个一般问题进行了电子邮件调查,并对其他变量进行了进一步的调查。对这三种 EHD 的 40 个核心变量以及每种 EHD 的所有变量、美国 MS CDM 和观察性医疗结局伙伴关系(OMOP)CDM 中的变量进行了可用性比较,并根据具体标准进行了标记。

结果

所有 EHD 的管理者都确认,在获得适当的批准后,他们愿意将其数据库与学术机构共享。区域性社区数据库在 2015 年包含 119 万人,其中 85%的核心变量。全国理赔数据库每年进行一次抽样,在 2014 年包含 540 万人,其中 55%的核心变量。电子病历数据库包含 60 家医院 2015 年的 300 万住院患者,其中 80%的核心变量。与 MS CDM 或 OMOP CDM 相比,三种 EHD 的变量比例(可获得或可从原始来源转换/衍生的变量)分别为 24%-83%或 45%-73%。

结论

这些 EHD 为中国药品上市后安全性监测和药物流行病学研究提供了潜在价值。未来有必要对这些 EHD 或中国其他数据源的质量和完整性进行评估。

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