Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 3, 2023
Date Accepted: Aug 24, 2023
Date Submitted to PubMed: Aug 24, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Scoping review to identify and describe integrated contemporary real-world studies databases from three diverse healthcare systems in Asia: Taiwan, India, and Thailand
ABSTRACT
Background:
We currently have very limited information on current trends for using real-world data (RWD) warehouses for research in Asia.
Objective:
We sought to identify linked contemporary databases and explore the trends and patterns for RWD generation among countries with contrasting economies and healthcare reimbursement systems. We chose three representative target countries (Taiwan, India, and Thailand) with diverse economies and healthcare settings.
Methods:
We performed a scoping review using a PubMed literature search with filters for the English language and the last five years to retrieve citations describing RWD from Taiwan, India, and Thailand. The literature search combined MeSH terms and keywords in three concepts. Retrieved studies were exported into Covidence for screening of studies against the eligibility criteria, and data extraction. Studies were eligible if they used EMR/EHR, health insurance/administrative claims, clinical registries, or pharmacy databases, and collated research data across >1 hospital/clinic in at least one of the target countries.
Results:
Of the 2277 studies retrieved, 833 were eligible, including 10.6% of cross-country collaboration studies (CCCS), and the rest were single-county studies (SCS). Of the SCS, 623 (74.7%) were from Taiwan, 81 (9.7%) from India, and 41 (4.9%) from Thailand. India and Thailand had higher CCCS than Taiwan (39%, 43% and 7.6%, respectively). From 2017-2022, India and Thailand saw ~18% and ~14% annual increase in studies, respectively, while Taiwan remained stable. Comparative effectiveness Research (CER) was predominant in Taiwan (66% of SCS), but less common in India (15%) and Thailand (27%). CER percentages in CCCS were similar across the three countries, ranging from 19%–29%. Use of EMR/EHR in SCS was highest in India (56%), and lowest in Taiwan (11%) but increased from 3% to 19% from 2017 to 2022. Registries were used in >80% of CCCS and 79% of Thailand SCS but in <50% of SCS from Taiwan and India. Claims data was used in most of Taiwan SCS (74%). Cardiology/metabolic disorder was the main study area, accounting for 27% of overall and 44% of CCCS. From 2017 to 2022, studies from oncology grew from 17% to 25%, and infectious diseases/vaccines from 2% to 9%. Average SCS duration varied across countries (Taiwan: 10.2 years, India: 5.4 years, Thailand: 7.5 years). The time lag from the end of data collected to the year of publication varied, being 7.1, 3.7 and 4.8 years for SCS in Taiwan, India and Thailand, respectively. The mean study sample size was larger for SCS in Taiwan and India, and the CCCS with Taiwan had the largest study size (~3.4 million).
Conclusions:
This scoping review has identified some clear differences in the utilised RWD, as well as time-dependent trends, that at least partly reflect the divergent economic and clinical settings in Taiwan, India, and Thailand. Clinical Trial: International Registered Report Identifier (IRRID): RR2-10.2196/43741
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