Cancer studies based on secondary data analysis of the Taiwan's National Health Insurance Research Database

Chiang, Jui-Kun; Lin, Chih‐Wen; Wang, Chun-Lung; Koo, Malcolm; Kao, Yee-Hsin

doi:10.1097/md.0000000000006704

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…The program has a coverage rate of over 99% of Taiwan’s 23 million residents. More than 20,000 medical care facilities, including hospitals, clinics, pharmacies, and medical laboratories, which represent over 93% of all health care facilities in Taiwan, were contracted by the NHI scheme [12] . Under the universal health coverage program, virtually all health care services, including consulting and treatment expenses for inpatient and ambulatory care, dental services, traditional Chinese medicine therapies, physical rehabilitation, and home care, are covered.…”

Section: Methodsmentioning

confidence: 99%

Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study

Chang

Tsai

Kung

et al. 2018

Translational Oncology

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BACKGROUND: Increasing bodies of evidence suggest that metformin may be beneficial in the primary prevention of colorectal cancer (CRC), and a dose–response relationship has been reported. However, long-term epidemiological observations between the treatment period, cumulative dose, and intensity of metformin and CRC are rarely reported. The aim of this study was to identify the association between the effect of metformin and CRC development in a nationwide cohort study. METHODS: This nationwide population-based study examined a cohort of 1,000,000 patients randomly sampled from individuals enrolled in the Taiwan National Health Insurance system. Patients with newly diagnosed type 2 diabetes mellitus (DM) between 1997 and 2007 were enrolled. A statistical variables, including the demographic data, treatment period, cumulative dose, and intensity of metformin use, was compared between patients developing CRC and those without CRC. RESULTS: This study included 47,597 patients. The mean follow-time was 7.17 ± 3.21 years. After adjustment, metformin use was an independent protective factor against CRC development (P < .001). Although the protective ability of metformin against CRC development was reduced during long-term therapy, the risk of CRC decreased progressively with a higher cumulative dose or higher intensity of metformin use (both P < .001). CONCLUSION: This study revealed that metformin use significantly reduced the risk of CRC in a dose-dependent manner in patients with type 2 DM in the Taiwanese population. However, a gradual decline in medication adherence may reduce the protective ability of metformin against CRC development during long-term therapy.

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Section: Methodsmentioning

confidence: 99%

Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study

Chang

Tsai

Kung

et al. 2018

Translational Oncology

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“…TNBCs have highly unstable genomes and their presence has been linked to several features among patients; these include frequent diagnosed among younger women, a larger size tumor, and a higher propensity towards the development of metastases. 2 At the early stages of disease, TNBC patients are often discovered with visceral metastasis (approximately 20%-30%, particularly of the lung and brain) and commonly there is an involvement of the lymph nodes. 3 There is consensus that chemotherapy, including taxanes, anthracyclines, and platinum agents, is the only treatment option for TNBC patients.…”

Section: Introductionmentioning

confidence: 99%

Different mechanisms involved in the berberine‐induced antiproliferation effects in triple‐negative breast cancer cell lines

Lin

Chiu

Tsai³

et al. 2019

J of Cellular Biochemistry

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Background/Aim: Berberine (BBR) is known to be effective at inhibiting cell proliferation and promoting apoptosis in various cancer cells. However, the effects of BBR on triple-negative breast cancer (TNBC) cells remain unclear.The aim of this study was to investigate the cell inhibition effects of BBR on different subtypes of TNBC cells. Methods: Using human TNBC cell lines of different subtypes, namely, MDA-MB-231, MDA-MB-468, MDA-MB-453, and BT-549 as in vitro models, antiproliferative effects of BBR were investigated by 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide assay, trypan blue exclusion assay, and clonogenic assay. Furthermore, cell apoptosis and autophagy were analyzed by flow cytometry, immunofluorescent staining, and LC3 Ⅰ/Ⅱ-targeted Western blotting. Various cell growth-related signaling pathways (AKT/ERK/p38) and the expression of proteins present in various cell cycle kinase complexes were analyzed by Western blotting. Results: BBR concentration-dependently suppressed cell proliferation in MDA-MB-468 (0, 3, 6, and 12 μM) and MDA-MB-231 (0, 6.25, 12.5, and 25 μM). The inhibitory effect was not brought about by inducing cell apoptosis, necrosis, or autophagy. Cell cycle analysis disclosed an increased S+G2/M fraction among the BBR-treated MDA-MB-231 and MDA-MB-453 cells; while with the BBRtreated MDA-MB-468 and BT-549 lines, an increased G0/G1 fraction was found. In MDA-MB-231 and MDA-MB-453 cells, by Western blotting, BBR decreased the expression of Cyclin A and CDK1, On the other hand, in BBR-treated MDA-MB-468 and BT-549 cells, there was a decrease in Cyclin D and CDK4 expression. Conclusion: Our results demonstrate that the antiproliferation effects of BBR occur via different mechanisms in different subtypes of TNBC cells,Abbreviations: BBR, berberine; BL1, basal-like1; BL2, basal-like2; ER, estrogen receptor; HER2, human epidermal growth factor receptor 2; LAR, luminal androgen receptor; M, mesenchymal; PD-1, programmed death-1; PD-L1, programmed death-1 ligand; PR, progestin receptor; ROS, reactive oxygen species; TNBC, triple-negative breast cancer.

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“…South Korea built its National Health Insurance Research Database, which functions to make secondary compensation for catastrophic expenditures; it also provides specific datasets to researchers for scientific research, especially for public health governance and infectious disease monitoring through data correlation [ 36 ]. The medical insurance database of Taiwan is used for research on cancer treatment [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

Medical Insurance Information Systems in China: Mixed Methods Study

Liu

2020

JMIR Med Inform

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Background Since the People’s Republic of China (PRC), or China, established the basic medical insurance system (MIS) in 1998, the medical insurance information systems (MIISs) in China have effectively supported the operation of the MIS through several phases of development; the phases included a stand-alone version, the internet, and big data. In 2018, China’s national medical security systems were integrated, while MIISs were facing reconstruction. We summarized China’s experience in medical insurance informatization over the past 20 years, aiming to provide a reference for the building of a new basic MIS for China and for developing countries. Objective This paper aims to sort out medical insurance informatization policies throughout the years, use questionnaires to determine the status quo of provincial MIIS-building in China and the relevant policies, provide references and suggestions for the top-level design and implementation of the information systems in the transitional period of China’s MIS reform, and provide a reference for the building of MIISs in developing countries. Methods We conducted policy analysis by collecting the laws, regulations, and policy documents—issued from 1998 to 2020—on China's medical insurance and its informatization; we also analyzed the US Health Insurance Portability and Accountability Act and other relevant policies. We conducted a questionnaire survey by sending out questionnaires to 31 Chinese, provincial, medical security bureaus to collect information about network links, system functions, data exchange, standards and specifications, and building modes, among other items. We conducted a literature review by searching for documents about relevant laws and policies, building methods, application results, and other documents related to MIISs; we conducted searches using PubMed, Elsevier, China National Knowledge Infrastructure, and other major literature databases. We conducted telephone interviews to verify the results of questionnaires and to understand the focus issues concerning the building of China’s national MIISs during the period of integration and transition of China's MIS. Results In 74% (23/31) of the regions in China, MIISs were networked through dedicated fiber optic lines. In 65% (20/31) of the regions in China, MIISs supported identity recognition based on both ID cards and social security cards. In 55% (17/31) of the regions in China, MIISs at provincial and municipal levels were networked and have gathered basic medical insurance data, whereas MIISs were connected to health insurance companies in 35% (11/31) of the regions in China. China’s MIISs are comprised of 11 basic functional modules, among which the modules of business operation, transregional referral, reimbursement, and monitoring systems are widely applied. MIISs in 83% (20/24) of Chinese provinces have stored data on coverage, payment, and settlement compensation of medical insurance. However, in terms of data security and privacy protection, pertinent policies are absent and data utilization is not in-depth enough. Respondents to telephone interviews universally reflected on the following issues and suggestions: in the period of integration and transition of MISs, close attention should be paid to the top-level design, and repeated investment should be avoided for the building of MIISs; MIISs should be adapted to the health care reform, and efforts should be made to strengthen the informatization support for the reform of payment methods; and MIISs should be adapted for the widespread application of mobile phones and should provide insured persons with more self-service functions. Conclusions In the future, the building of China’s basic MIISs should be deployed at the national, provincial, prefectural, and municipal levels on a unified basis. Efforts should be made to strengthen the development of standard codes, data exchange, and data utilization. Work should be done to formulate the rules and regulations for security and privacy protection and to balance the right to be informed with the mining and utilization of big data. Efforts should be made to intensify the interconnectivity between MISs and other health systems and to strengthen the application of medical insurance information in public health monitoring and early warning systems; this would ultimately improve the degree of trust from stakeholders, including individuals, medical service providers, and public health institutions, in the basic MIISs.

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Cancer studies based on secondary data analysis of the Taiwan's National Health Insurance Research Database

Cited by 8 publications

References 16 publications

Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study

Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study

Different mechanisms involved in the berberine‐induced antiproliferation effects in triple‐negative breast cancer cell lines

Medical Insurance Information Systems in China: Mixed Methods Study

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