Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pharmacoepidemiol Drug Saf. 2019 May;28(5):593-600. doi: 10.1002/pds.4713. Epub 2019 Jan 16.
The Chang Gung Research Database (CGRD), the largest multi-institutional electronic medical records (EMR) collection in Taiwan, provides good access for researchers to efficiently use the standardized patient-level data. This study evaluates the capacity and representativeness of the CGRD to promote secondary use of EMR data for clinical research with more accurate estimates.
The National Health Insurance Research Database (NHIRD) which covers over 99.9% of the Taiwanese population served as the comparator in this study. We compare the data components of the CGRD with the NHIRD, including records for health care facilities, patients, diagnoses, drugs, and procedures. Using the chi-square test, we compared the distributions of age categories and sex of patients, and the rates of their health conditions between NHIRD and CGRD based on the year 2015.
The CGRD contains more clinical information such as pathological and laboratory results than the NHIRD. The CGRD includes 6.1% of outpatients and 10.2% of hospitalized patients from the NHIRD. We found the CGRD includes more elderly outpatients (23.5% vs 12.5%) and pediatric inpatients (19.7% vs 14.4%) compared with the NHIRD. We found patients' sex distributions were similar between CGRD and NHIRD, but coverage rates of severe conditions, such as cancer, were higher than other health conditions in CGRD.
The CGRD could serve as the basis for accurate estimates in medical studies. However, researchers should pay special attention to selection biases since patients' characteristics from CGRD differ from those of the national database.
长庚研究数据库(CGRD)是台湾最大的多机构电子病历(EMR)集合,为研究人员提供了很好的访问途径,能够高效地使用标准化的患者级数据。本研究评估了 CGRD 的容量和代表性,以促进使用 EMR 数据进行更准确估计的临床研究的二次利用。
本研究以涵盖台湾 99.9%以上人口的全民健康保险研究数据库(NHIRD)作为对照。我们比较了 CGRD 与 NHIRD 的数据组成部分,包括医疗机构、患者、诊断、药物和程序记录。使用卡方检验,我们比较了 NHIRD 和 CGRD 中患者的年龄类别和性别分布,以及他们的健康状况发生率,这些数据基于 2015 年。
CGRD 包含比 NHIRD 更多的临床信息,如病理和实验室结果。CGRD 包含了 NHIRD 中 6.1%的门诊患者和 10.2%的住院患者。与 NHIRD 相比,我们发现 CGRD 包含更多的老年门诊患者(23.5%比 12.5%)和儿科住院患者(19.7%比 14.4%)。我们发现 CGRD 与 NHIRD 之间患者的性别分布相似,但 CGRD 中癌症等严重疾病的覆盖率高于其他健康状况。
CGRD 可以作为医学研究中准确估计的基础。然而,研究人员应该特别注意选择偏差,因为 CGRD 中的患者特征与国家数据库不同。