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真实世界证据和真实世界数据对软组织肉瘤管理决策的贡献。

Contributions of Real-World Evidence and Real-World Data to Decision-Making in the Management of Soft Tissue Sarcomas.

机构信息

Dana-Farber Cancer Institute and Ludwig Center at Harvard, Boston, Massachusetts, USA.

Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.

出版信息

Oncology. 2021;99 Suppl 1:3-7. doi: 10.1159/000515266. Epub 2021 Apr 14.

Abstract

Real-world data are defined as data relating to any aspect of a patient's health status collected in the context of routine health surveillance and medical care delivery. Sources range from insurance billing claims through to electronic surveillance data (e.g., activity trackers). Real-world data derive from large populations in diverse clinical settings and thus can be extrapolated more readily than clinical trial data to patients in different clinical settings or with a variety of comorbidities. Real-world data are used to generate real-world evidence, which might be regarded as a "meta-analysis" of accumulated real-world data. Increasingly, regulatory authorities are recognizing the value of real-world data and real-world evidence, especially for rare diseases where it may be practically unfeasible to conduct randomized controlled trials. However, the quality of real-world evidence depends on the quality of the data collected which, in turn, depends on a correct pathological diagnosis and the homogeneous behaviour of a reliably defined and consistent disease entity. As each of the more than 80 varieties of soft tissue sarcoma (STS) types represents a distinct disease entity, the situation is exceedingly complicated. Discordant diagnoses, which affect data quality, present a major challenge for use of real-world data. As real-world data are difficult to collect, collaboration across sarcoma reference institutions and sophisticated information technology solutions are required before the potential of real-world evidence to inform decision-making in the management of STS can be fully exploited.

摘要

真实世界数据是指在常规健康监测和医疗保健服务提供过程中收集的与患者健康状况相关的任何方面的数据。这些数据的来源广泛,从保险计费索赔到电子监测数据(如活动追踪器)都有涉及。真实世界数据来自于不同临床环境中的大量人群,因此可以比临床试验数据更易于推断到不同临床环境或具有多种合并症的患者身上。真实世界数据用于生成真实世界证据,这可以被视为对积累的真实世界数据的“荟萃分析”。监管机构越来越认识到真实世界数据和真实世界证据的价值,特别是对于罕见疾病,因为在这些疾病中进行随机对照试验可能实际上是不可行的。然而,真实世界证据的质量取决于所收集数据的质量,而这又取决于正确的病理诊断以及可靠定义和一致的疾病实体的同质行为。由于超过 80 种软组织肉瘤 (STS) 类型中的每一种都代表着一个独特的疾病实体,因此情况非常复杂。影响数据质量的不一致诊断给真实世界数据的应用带来了重大挑战。由于真实世界数据难以收集,因此需要肉瘤参考机构之间的合作以及复杂的信息技术解决方案,才能充分利用真实世界证据在 STS 管理决策中的潜力。

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