The NEPI Foundation - Swedish Network for Pharmacoepidemiology, Linköping University , Linköping, Sweden.
Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology, Ghent University , Ghent, Belgium.
Expert Rev Clin Pharmacol. 2020 Sep;13(9):925-934. doi: 10.1080/17512433.2020.1805314. Epub 2020 Sep 29.
Technical and logical breakthroughs have provided new opportunities in medicine to use knowledge bases and large-scale clinical data (real-world) at point-of-care as part of a learning healthcare system to diminish the knowledge-practice gap.
The article is based on presentations, discussions and recommendations from an international scientific workshop. Value, research needs and funding avenues of knowledge bases and access to real-world data as well as transparency and incorporation of patient perspectives are discussed.
Evidence-based, publicly funded, well-structured and curated knowledge bases are of global importance. They ought to be considered as a public responsibility requiring transparency and handling of conflicts of interest. Information has to be made accessible for clinical decision support systems (CDSS) for healthcare staff and patients. Access to rich and real-world data is essential for a learning health care ecosystem and can be augmented by data on patient-reported outcomes and preferences. This field can progress by the establishment of an international policy group for developing a best practice guideline on the development, maintenance, governance, evaluation principles and financing of open-source knowledge bases and handling of real-world data.
技术和逻辑上的突破为医学提供了新的机会，可以在护理点使用知识库和大规模临床数据（真实世界数据），作为学习型医疗保健系统的一部分，以缩小知识与实践之间的差距。
本文基于国际科学研讨会的演讲、讨论和建议。本文讨论了知识库的价值、研究需求和资金途径，以及获取真实世界数据的途径，还有透明度和纳入患者观点的问题。
基于证据、公共资助、结构良好且经过精心整理的知识库具有全球重要性。它们应该被视为公共责任，需要透明处理利益冲突。信息必须可供医疗保健工作人员和患者的临床决策支持系统（CDSS）使用。为了实现学习型医疗保健生态系统，获取丰富的真实世界数据至关重要，患者报告的结果和偏好数据也可以对此进行补充。可以通过建立一个国际政策小组来推进这一领域的发展，该小组将制定关于开发、维护、治理、评估原则和开源知识库的资金以及真实世界数据处理的最佳实践指南。
