Discharge status validation of the Chang Gung Research database in Taiwan

Huang, Yu‐Tung; Chen, Ying-Jen; Chang, Shang‐Hung; Kuo, Chang‐Fu; Chen, Meihua

doi:10.1016/j.bj.2021.12.006

Cited by 16 publications

(15 citation statements)

References 33 publications

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“…The Taiwan NHI program is a compulsory, single-payer health insurance program that covers over 99% of Taiwan’s population [ 47 ]. The CGRD, containing detailed individual patient-level EHR including diagnosis, prescription, and laboratory test results, has been validated in some disease populations [ 46 , 48 ]. We conducted this analysis using the CGRD data from January 2003 to December 2018.…”

Section: Methodsmentioning

confidence: 99%

Denosumab Is Superior to Raloxifene in Lowering Risks of Mortality and Ischemic Stroke in Osteoporotic Women

et al. 2023

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Both osteoporosis and cardiovascular disease (CVD) share similar pathways in pathophysiology and are intercorrelated with increased morbidity and mortality in elderly women. Although denosumab and raloxifene are the current guideline-based pharmacological treatments, their impacts on cardiovascular protection are yet to be examined. This study aimed to compare mortality rate and cardiovascular events between denosumab and raloxifene in osteoporotic women. Risks of CVD development and all-cause mortality were estimated using Cox proportional hazard regression. A total of 7972 (3986 in each group) women were recruited between January 2003 and December 2018. No significant difference between denosumab and raloxifene was observed in composite CVDs, myocardial infarction, or congestive heart failure. However, comparison of the propensity score matched cohorts revealed that patients with proportion of days covered (PDC) ≥60% had lower incidence of ischemic stroke in the denosumab group than that in the raloxifene group (aHR 0.68; 95% CI 0.47–0.98; p = 0.0399). In addition, all-cause mortality was lower in the denosumab group than in the raloxifene group (aHR 0.59; 95% CI 0.48–0.72; p = 0.001), except in patients aged <65 y/o in this cohort study. We concluded that denosumab is superior to raloxifene in lowering risks of all-cause mortality and certain ischemic strokes in osteoporotic women.

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Section: Methodsmentioning

confidence: 99%

Denosumab Is Superior to Raloxifene in Lowering Risks of Mortality and Ischemic Stroke in Osteoporotic Women

et al. 2023

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“… 16 , 17 , 21 , 22 , 23 The data representativeness and the validity of diagnostic codes in the CGRD have also been validated. 15 , 16 , 20 , 24 , 25 , 26 , 27 This study protocol was approved, with waiver of informed consent, by the institutional review board of the Chang Gung Medical Foundation, and we followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline in the reporting of our results.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Sodium-Glucose Cotransporter 2 Inhibitors vs Glucagonlike Peptide-1 Receptor Agonists and Incidence of Dry Eye Disease in Patients With Type 2 Diabetes in Taiwan

Hung

Chang

et al. 2022

JAMA Netw Open

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ImportanceSodium-glucose cotransporter 2 (SGLT2) inhibitors have been found to improve low-grade systemic and tissue inflammation; however, the association between SGLT2 inhibitor use and the incidence of dry eye disease (DED) has not been explored.ObjectiveTo investigate the association between SGLT2 inhibitor use and dry eye disease in patients with type 2 diabetes (T2D).Design, Setting, and ParticipantsA retrospective cohort analysis of the largest multi-institutional electronic medical records database in Taiwan was conducted to identify patients with T2D newly receiving SGLT2 inhibitors or glucagonlike peptide-1 receptor agonists (GLP-1 RAs) from 2016 to 2018. Data analysis was performed from March 1 to May 31, 2022. Propensity scores with inverse probability of treatment weighting were generated to enable homogeneous comparisons between the 2 groups.ExposuresTreatment with SGLT2 inhibitors or GLP-1 RAs.Main Outcomes and MeasuresIncident dry eye disease, which was defined by clinical diagnoses, plus the related drug prescription. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for the risk of DED.ResultsA total of 10 038 and 1077 T2D patients newly receiving SGLT2 inhibitors (mean [SD] age, 59.5 [12.1] years; 5689 [56.7%] men) or GLP-1 RAs (mean [SD] age, 58.5 [41.2] years; 587 [54.5%] men), respectively, were included in the analysis. The incidence of DED was lower in patients newly receiving SGLT2 inhibitors (9.0 events per 1000 person-years) compared with those receiving GLP-1 RAs (11.5 events per 1000 person-years), yielding a hazard ratio of 0.78 (95% CI, 0.68-0.89). Subgroup analyses indicated that the lowered DED risks associated with SGLT2 inhibitors in patients with T2D were similar across different age, sex, blood glucose level, and kidney function groups. Results from the sensitivity analyses (including the propensity score–matching approach, on-treatment analyses, and different follow-up periods of 1, 2, and 3 years) were similar to the main analyses.Conclusions and RelevanceThe findings of this study suggest that patients with T2D newly receiving SGLT2 inhibitors may have a lower risk for DED compared with those receiving GLP-1 RAs. Prospective studies are needed to analyze these results.

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“…Briefly, the CGRD contains individual patient-level EHR from the CGMH, providing 10–12% of health services reimbursed by Taiwan National Health Insurance (NHI) program in 2018 [ 19 ]. The data generalizability of CGRD has been validated in some disease populations [ 20 , 21 ], and the laboratory results have been used in kidney [ 18 , 22 , 23 ] and heart studies [ 24 ]. The CGRD data from January 2003 to December 2018 were used for the analysis.…”

Section: Methodsmentioning

confidence: 99%

Comparative Adverse Kidney Outcomes in Women Receiving Raloxifene and Denosumab in a Real-World Setting

et al. 2022

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Both osteoporosis and kidney diseases are common and intercorrelate to increase morbidity and mortality in elderly women. This study aimed to compare adverse kidney outcome between women initiated with denosumab and a matched group of raloxifene initiators using propensity score matching methods in a large healthcare delivery system in Taiwan. The risks of adverse kidney outcomes were estimated using Cox proportional hazard regression and the change in kidney function over time was analyzed using the linear mixed model. A total of 9444 (4722 in each group) women were identified who matched the inclusion criteria between January, 2003 and December, 2018. Denosumab use was significantly associated with higher risk of eGFR decline ≥ 30% from baseline than raloxifene use (aHR: 1.26; 95% CI: 1.16–1.36, p < 0.0001). The mean change in eGFR over time was 1.24 mL/min/1.73 m2 per year in the denosumab group and 0.45 mL/min/1.73 m2 per year in the raloxifene group (p = 0.0004). However, the risks of acute kidney injury (10.53%) and chronic dialysis (0.66%) in this study cohort were not significantly different for the two anti-osteoporosis treatments. Close monitoring of the residual kidney function and treatment effect is needed in those with denosumab.

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Discharge status validation of the Chang Gung Research database in Taiwan

Cited by 16 publications

References 33 publications

Denosumab Is Superior to Raloxifene in Lowering Risks of Mortality and Ischemic Stroke in Osteoporotic Women

Denosumab Is Superior to Raloxifene in Lowering Risks of Mortality and Ischemic Stroke in Osteoporotic Women

Comparison of Sodium-Glucose Cotransporter 2 Inhibitors vs Glucagonlike Peptide-1 Receptor Agonists and Incidence of Dry Eye Disease in Patients With Type 2 Diabetes in Taiwan

Comparative Adverse Kidney Outcomes in Women Receiving Raloxifene and Denosumab in a Real-World Setting

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