Shih-Chieh Shao1,2, Yuk-Ying Chan3, Yea-Huei Kao Yang2, Swu-Jane Lin4, Ming-Jui Hung5, Rong-Nan Chien6, Chi-Chun Lai7, Edward Chia-Cheng Lai2,8. 1. Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan. 2. School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 3. Department of Pharmacy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 4. Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA. 5. Section of Cardiology, Department of Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan. 6. Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 7. Department of Ophthalmology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 8. Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Jenni Ilomäki; J Simon Bell; Adrienne Y L Chan; Anna-Maija Tolppanen; Hao Luo; Li Wei; Edward Chia-Cheng Lai; Ju-Young Shin; Giorgia De Paoli; Romin Pajouheshnia; Frederick K Ho; Lorenna Reynolds; Kui Kai Lau; Stephen Crystal; Wallis C Y Lau; Kenneth K C Man; Ruth Brauer; Esther W Chan; Chin-Yao Shen; Ju Hwan Kim; Terry Y S Lum; Sirpa Hartikainen; Marjaana Koponen; Evelien Rooke; Marloes Bazelier; Olaf Klungel; Soko Setoguchi; Jill P Pell; Sharon Cook; Ian C K Wong Journal: CNS Drugs Date: 2020-09 Impact factor: 5.749