Shau Wen-Yi, Setia Sajita, Shinde Salil, Santoso Handoko, Furtner Daniel
Medical Affairs, Emerging Asia, Pfizer Corporation Hong Kong Limited, Quarry Bay, Hong Kong.
Executive Office Transform Medical Communications Limited, Wanganui, New Zealand.
Perspect Clin Res. 2023 Jul-Sep;14(3):108-113. doi: 10.4103/picr.picr_193_22. Epub 2023 Jun 5.
Evidence generated by randomized controlled trials (RCTs) does not often represent the patient journey and clinical outcomes in the real world due to limited external validity or generalizability. Studies based on real-world data are intended to generalize results to the broader population; however, if the influence of external factors or confounders is not effectively managed, the cause-and-effect relationship and internal validity may be challenged, resulting in flawed results. The collection of quality real-world evidence (RWE) is crucial in Asia as there is often an underrepresentation of Asian populations in RCTs. In addition, few countries in Asia are catching up with the Western world in issuing practical foundational principles and guidance for conducting and adopting evidence for regulatory and reimbursement decisions. However, privacy and data protection laws are generally lagging behind technological developments in electronic medical records. While leveraging RWE in clinical and regulatory decision-making holds excellent potential, collective efforts across industry, governments, and research institutions are required for generating standardized practices and building capabilities for developing fit-for-purpose RWE in Asia.
由于外部有效性或普遍性有限,随机对照试验(RCT)产生的证据往往不能代表现实世界中的患者病程和临床结果。基于真实世界数据的研究旨在将结果推广到更广泛的人群;然而,如果外部因素或混杂因素的影响没有得到有效控制,因果关系和内部有效性可能会受到挑战,从而导致结果存在缺陷。在亚洲,收集高质量的真实世界证据(RWE)至关重要,因为亚洲人群在RCT中的代表性往往不足。此外,在发布用于监管和报销决策的实施和采用证据的实用基本原则和指南方面,亚洲很少有国家能赶上西方世界。然而,隐私和数据保护法律总体上落后于电子病历技术的发展。虽然在临床和监管决策中利用RWE具有巨大潜力,但需要行业、政府和研究机构共同努力,以形成标准化做法,并建立在亚洲开发适用的RWE的能力。