Taiwan's National Health Insurance Research Database: past and future.
Cheng Yang Hsieh,Chien Chou Su,Shih Chieh Shao,Shih Chieh Shao,Sheng-Feng Sung,Swu Jane Lin,Yea Huei Kao Yang,Edward Chia Cheng Lai +7 more
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TLDR
It is believed that NHIRD with multiple data sources could represent a powerful research engine with enriched dimensions and could serve as a guiding light for real-world evidence-based medicine in Taiwan.Abstract:
Taiwan's National Health Insurance Research Database (NHIRD) exemplifies a population-level data source for generating real-world evidence to support clinical decisions and health care policy-making. Like with all claims databases, there have been some validity concerns of studies using the NHIRD, such as the accuracy of diagnosis codes and issues around unmeasured confounders. Endeavors to validate diagnosed codes or to develop methodologic approaches to address unmeasured confounders have largely increased the reliability of NHIRD studies. Recently, Taiwan's Ministry of Health and Welfare (MOHW) established a Health and Welfare Data Center (HWDC), a data repository site that centralizes the NHIRD and about 70 other health-related databases for data management and analyses. To strengthen the protection of data privacy, investigators are required to conduct on-site analysis at an HWDC through remote connection to MOHW servers. Although the tight regulation of this on-site analysis has led to inconvenience for analysts and has increased time and costs required for research, the HWDC has created opportunities for enriched dimensions of study by linking across the NHIRD and other databases. In the near future, researchers will have greater opportunity to distill knowledge from the NHIRD linked to hospital-based electronic medical records databases containing unstructured patient-level information by using artificial intelligence techniques, including machine learning and natural language processes. We believe that NHIRD with multiple data sources could represent a powerful research engine with enriched dimensions and could serve as a guiding light for real-world evidence-based medicine in Taiwan.read more
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Use of hydrochlorothiazide and risk of skin cancer: a nationwide Taiwanese case-control study.
Anton Pottegård,Sidsel Arnspang Pedersen,Sidsel Arnspang Pedersen,Sigrún Alba Jóhannesdóttir Schmidt,Chaw Ning Lee,Chao Kai Hsu,Tzu Chi Liao,Shih Chieh Shao,Shih Chieh Shao,Edward Chia Cheng Lai +9 more
TL;DR: Use of HCTZ appears safe in terms of skin cancer risk in an Asian population, and the null findings were robust across subgroup and sensitivity analyses.
Journal ArticleDOI
Performance of ICD-10-CM Diagnosis Codes for Identifying Acute Ischemic Stroke in a National Health Insurance Claims Database.
Meng-Tsang Hsieh,Meng-Tsang Hsieh,Cheng Yang Hsieh,Tzu-Tung Tsai,Yi Ching Wang,Sheng-Feng Sung +5 more
TL;DR: The validity of various case definition algorithms for AIS based on ICD-10-CM coding can be demonstrated and can provide a reference for future claims-based stroke research.
Journal ArticleDOI
Metformin Use Is Associated with a Lower Risk of Inflammatory Bowel Disease in Patients with Type 2 Diabetes Mellitus
TL;DR: A reduced risk of IBD is consistently observed in patients with type 2 diabetes mellitus who have been treated with metformin, and a dose-response pattern was observed while comparing the tertiles of cumulative duration of met formin therapy to never users.
Journal ArticleDOI
Health Care Costs Associated With Macrovascular, Microvascular, and Metabolic Complications of Type 2 Diabetes Across Time: Estimates From a Population-Based Cohort of More Than 0.8 Million Individuals With Up to 15 Years of Follow-up
TL;DR: The cost estimates from this study are crucial for parameterizing diabetes economic simulation models to quantify the economic impact of clinical outcomes and determine cost-effective interventions.
Journal ArticleDOI
Validation of ICD-10-CM Diagnosis Codes for Identification of Patients with Acute Hemorrhagic Stroke in a National Health Insurance Claims Database.
Meng-Tsang Hsieh,Kuo-Chang Huang,Cheng Yang Hsieh,Tzu-Tung Tsai,Li-Ching Chen,Sheng-Feng Sung +5 more
TL;DR: The performance of ICD-10-CM codes for identifying acute hemorrhagic stroke in Taiwan's National Health Insurance claims database has not been assessed as discussed by the authors, however, the authors in this paper aim to construct and validate the case definitions for acute hemorrhaged stroke based on ICD10CM diagnostic codes, which may offer a reference for future claims-based stroke studies.
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