JMIR Publications

ABSTRACT

Background:

Asia consists of diverse nations with extremely variable healthcare systems and socio-economic intricacies. Integrated real-world data (RWD) research warehouses provide vast interconnected datasets that uphold statistical rigor. However, their intricate details remain underexplored, restricting their broader application in healthcare research, policies and partnerships.

Objective:

Building on our prior research that analyzed integrated RWD warehouses in India, Thailand and Taiwan, this study is an extension to seven distinct Asian healthcare systems: Hong Kong, Indonesia, Malaysia, Pakistan, the Philippines, Singapore, and Vietnam. We aimed to map the evolving landscape of RWD use, elucidate the current state of real-world evidence (RWE) generation from integrated databases, and understand evolving preferences for RWD methodologies and database(s) use.

Methods:

A systematic scoping review methodology was employed, centering on contemporary English literature search on PubMed. Rigorous screening followed defined eligibility criteria to pinpoint studies utilizing integrated RWD from multiple healthcare facilities in at least one of the seven target Asian nations. Target nations were archetyped as 'Global Collaborators' or 'Solo Scholars' based on their publication count and extent of Cross-Country Collaboration Studies (CCCS) versus Single Country Studies (SCS) over the five-year study period.

Results:

Out of the 1483 RWE research titles identified on May 9, 2023, 369 (24.9%) fulfilled the requirements for data extraction and subsequent analysis. Singapore, Hong Kong, and Malaysia contributed to ≥100 publications, each marked by a higher proportion of SCS at 51% (80/157), 66.2% (86/130), and 50% (50/100), respectively, and were classified as Solo Scholars. Indonesia, Pakistan, Vietnam and the Philippines had fewer publications and a higher proportion of CCCS at 78.8% (26/33), 58.1% (18/31), 74.1% (20/27), and 86.4% (19/22), respectively and were classified as Global Collaborators. Collaboration with the countries outside the seven target nations appeared in 84.2%–97.7% of the CCCS of each nation. Among target nations, Singapore and Malaysia emerged as preferred research partners for other nations. From 2018 to 2023, most nations displayed an increasing trend in study numbers, with Vietnam (24.5%) and Pakistan (21.2%) leading the growth; the only exception was the Philippines, which declined by -14.5%. Clinical registry databases were predominant across all CCCS from every target nation. For SCS, Indonesia, Malaysia, and the Philippines favored clinical registries; Singapore had a balanced usage of clinical registries and EMR/EHR, while Hong Kong, Pakistan, and Vietnam leaned towards EMR/EHR. Over 90% of the studies took more than 2 years from completion to publication.

Conclusions:

The observed variations in contemporary RWD publications across the 7 nations in Asia exemplify distinct research landscapes across nations that are partially explained by their diverse economic, clinical, and research settings. Nevertheless, recognizing these variations is pivotal for fostering tailored, synergistic strategies that amplify RWD's potential in guiding future healthcare research and policy decisions. Clinical Trial: RR2-10.2196/43741