The Chang Gung Research Database: Multi‐institutional real‐world data source for traditional Chinese medicine in Taiwan

Abstract

Background The Chang Gung Research Database (CGRD), the largest multi‐institutional electronic medical records collection in Taiwan, has been used to establish real‐world evidence related to traditional Chinese medicine (TCM). We aimed to evaluate patient characteristics and representativeness of TCM patients in CGRD. Methods We identified a cohort of patients who had TCM records both from CGRD and from Taiwan's National Health Insurance Database (NHIRD) during 2010–2015 to investigate the representativeness of CGRD for TCM uses. The NHIRD was considered as reference because it covers all medical claims from 99.9% of the entire Taiwanese population. We investigated the coverage rates of TCM patients within CGRD compared to NHIRD, and compared the characteristics of patients between CGRD and NHIRD including age, sex, and 15 health conditions. Results We identified 71 002 average annual patients within the CGRD, which accounted for 1.1% of the patients from the NHIRD. The patients from CGRD were older than those from NHIRD (≥65: 16.6% vs. 9.9% for CGRD vs. NHIRD). The ratios of female over male patients were 1.7 vs. 1.5 for CGRD vs. NHIRD. We found higher patient coverage rates for patients with major comorbidities in CGRD, specifically for neoplasm (9.2%) and mental disorders (6.0%). The most frequently prescribed Chinese herbal medicines in CGRD included Jia‐Wei‐Xiao‐Yao‐San, Xiang‐Sha‐Liu‐Jun‐Zi‐Tang and Gui‐Lu‐Er‐Xian‐Jiao. Conclusion Higher patient coverage rates were found in CGRD for TCM patients with major comorbidities. Investigators should note possible selection bias since TCM patient disorders may be more severe in CGRD than in the NHIRD.

Chinese herbal medicine is associated with higher body weight reduction than liraglutide among the obese population: A real-world comparative cohort study

“…The CGMHs provide CHM and Western medicine (WM) for patient care, comprising eight medical institutes with different hospital levels, and serve as the largest medical system in Taiwan (Ku et al, 2021). According to the statistics, CGMHs own 10,070 beds and admit more than 280,000 patients each year, supporting over 8,500,000 outpatient visits and 500,000 emergency department visits in 2015 (Shao et al, 2021). The huge amount of clinical data has made the CGRD become a great resource for clinical studies (Shao et al, 2021).…”

“…According to the statistics, CGMHs own 10,070 beds and admit more than 280,000 patients each year, supporting over 8,500,000 outpatient visits and 500,000 emergency department visits in 2015 (Shao et al, 2021). The huge amount of clinical data has made the CGRD become a great resource for clinical studies (Shao et al, 2021).…”

“…We retrieved the electronic medical records (EMR) from eight CGMHs to provide real-world evidence, which involved patient information demographics, clinical parameters, diagnostic information, prescription information, and other health care facility information (Shao et al, 2021). The selection period for treatment initiation was from 1 January 2013 to 31 December 2018, with baseline demographic data based on the 6 months period prior to initiation, including baseline weight, biochemical and physiological profiles, and comorbidities.…”

The association between mortality and use of Chinese herbal medicine among incident stage IV esophageal cancer patients: A retrospective cohort study with core herbs exploration

“…These data allowed us to trace patients’ outcomes afterward, even if the patient was deceased outside CGMH. Therefore, the possible registration and detection bias on death cause in CGRD could be eliminated ( Tsai et al, 2017 ; Shao et al, 2021 ).…”

Does medical disparity exist while treating severe mental illness patients with acute appendicitis in emergency departments? A real-world database study

“…The basic architecture for CGRD includes clinical, epidemiological, laboratory, nursing, and disease categories, and cancer registry data for inpatient, outpatient, and emergency patients. The CGRD has been collecting deidentified data on the current and previous health conditions of patients by using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes before 2016 and using ICD-10-CM codes afterwards [17].…”