Chang Gung Research Database: A multi-institutional database consisting of original medical records

Lin

et al. 2020

Sci Rep

We evaluated the efficacy of second-line hormonal therapy for treatment of metastatic castrationresistant prostate cancer (mcRpc) in a real-world retrospective study. We conducted a populationbased real-world cohort study of 258 mCRPC patients between 2014 and 2018 using the Chang Gung Research Database (CGRD) of Taiwan. The second-line hormonal therapy included abiraterone acetate and enzalutamide. The clinical efficacy outcomes were overall survival (OS) and prostate-specific antigen (PSA) doubling time. The median PSA level was also assessed. In total, 223 mCRPC patients who underwent second-line hormonal therapy met all of the inclusion and exclusion criteria for this study. Among them, 65 (29.1%) patients were in the PSA response group and 158 (70.9%) were in the non-response group. The median age was 72.9 years. The median OS was 12.3 months (range: 9.9-19.9 months) and 9.6 months (range: 5.3-15.9 months) in the response and non-response groups, respectively, and the respective PSA doubling times were 9.0 months (range: 4.4-11.6 months) and 3.9 months (range: 2.2-9.1 months), with a median follow-up period of 10.5 months. A significantly longer median oS was seen in the pSA response group. this real-world database study demonstrated that clinical outcomes of second-line hormonal therapy were better in patients with a pSA response. further studies are warranted to achieve a better understanding of second-line hormonal therapy for mcRpc in Asian populations.Androgen deprivation therapy (ADT) has been a mainstay of treatment for advanced prostate cancer (PCa) 1 . Eventually, patients with PCa will progress to castration-resistant prostate cancer (CRPC). In recent years, second-line hormonal therapies for metastatic CRPC (mCRPC) have become available, including abiraterone acetate (AA) and enzalutamide 2,3 . Both of them prolonged overall survival in patients with mCRPC who had disease progression.A randomized double-blind controlled study (COU-AA-301) of metastatic CRPC patients post-chemotherapy showed that AA therapy significantly increased overall survival (OS) and radiographic progression-free survival (rPFS) in comparison to placebo 2 . The COU-AA-302 trial also showed that AA increased OS and rPFS in metastatic CRPC patients pre-chemotherapy 4 . Meanwhile, the AFFIRM and PREVAIL studies showed that enzalutamide had significant benefits on OS and rPFS in metastatic CRPC patients, both post-and pre-chemotherapy 3,5 . AA and enzalutamide for treatment of metastatic CRPC have been approved by the Taiwan Food and Drug

Section: Methodsmentioning

confidence: 99%

Second-line Hormonal Therapy for the Management of Metastatic Castration-resistant Prostate Cancer: a Real-World Data Study Using a Claims Database

Lin

et al. 2020

Sci Rep

“…These hospitals are located across Taiwan (http://www.chang-gung.com/en/index.aspx). The data in the CGRD include demographic data, inpatient and outpatient data, diagnostic codes, details of prescriptions and reports of microbiological, image and functional examinations [15]. More detailed information about CGRD had been reported in a previous article [16].…”

Section: Data Sourcementioning

confidence: 99%

Etiology and characteristics of patients with bronchiectasis in Taiwan: a cohort study from 2002 to 2016

Huang

Chung

et al. 2020

BMC Pulm Med

Background: Bronchiectasis is a chronic infectious respiratory disease with diverse causes and ethnic or geographic differences. However, few large-scale studies of its etiology have been conducted in Asia. This study aimed to determine the etiology and clinical features of bronchiectasis in Taiwan.Methods: This longitudinal cohort study investigated the etiology and clinical features of newly diagnosed noncystic fibrosis bronchiectasis patients from January 2002 to December 2016. The clinical, functional and microbiological data of patients were retrieved from the Chang Gung Research Database, which includes seven medical facilities throughout Taiwan. The index date was the date of the first bronchiectasis diagnosis. Known diseases that were diagnosed before the index date were regarded as etiologies of bronchiectasis. Results: The cohort comprised 15,729 adult patients with bronchiectasis. Idiopathic (32%) was the most common cause, followed by post-pneumonia (24%). Other causes included post-tuberculosis (12%), chronic obstructive pulmonary disease (14%), asthma (10%), gastroesophageal reflux disease (2%) and rheumatic diseases (2%). At diagnosis, 8487 patients had sputum culture. Pseudomonas aeruginosa (5.3%) was the most common bacteria, followed by non-tuberculosis mycobacteria (3.6%), Haemophilus influenzae (3.4%) and Klebsiella pneumoniae (3.1%), but 6155 (72.1%) had negative sputum cultures. Patients with post-tuberculosis had a higher sputum isolation rate of non-tuberculosis mycobacteria than P. aeruginosa. Patients with post-tuberculosis and post-pneumonia bronchiectasis had a higher frequency of chronic lung infection than other groups (p < 0.05). Clinical characteristics, such as gender, lung function, comorbidities and microbiology, were significantly different between idiopathic and known etiologies.Conclusions: Idiopathic, post-infection and tuberculosis constitute major bronchiectasis etiologies in Taiwan. Clinical characteristics and sputum microbiology were distinct among separate etiology phenotypes.

“…The Longitudinal Health Insurance Database 2000 (LHID2000), a subset database of the NHIRD, consists of 1 million insurants who were randomly statistically selected from all insurants in Taiwan in the year 2000. Age distribution, sex distribution, and healthcare costs did not differ significantly between the LHID2000 sample group and all enrollees in the NHIRD according to a report by the National Health Research Institutes and several validation studies. The LHID2000 has been used in several population‐based studies .…”

Section: Methodsmentioning

confidence: 90%

“…Comorbidities were defined using ICD‐9‐CM codes recorded in the claims data: DM (ICD‐9‐CM code: 250), hypertension (HTN) (ICD‐9‐CM codes: 401–405), chronic kidney disease (CKD) (ICD‐9‐CM codes: 403, 404, 585, and 586), liver cirrhosis (LC) (ICD‐9‐CM codes: 571.2, 571.5–571.6), cerebrovascular accident (CVA) (ICD‐9‐CM codes: 430–438), coronary artery disease (CAD) (ICD‐9‐CM codes: 410–414), systemic lupus erythematosus (SLE) (ICD‐9‐CM codes: 710.0), Sjögren syndrome (SS) (ICD‐9‐CM codes: 710.2), and psoriasis (ICD‐9‐CM codes: 696.1, 696.1) . Medical comorbidities were included if they appeared at least once in the diagnoses of inpatients or at least three times in the diagnoses of outpatients.…”

Section: Methodsmentioning

confidence: 99%

Real‐world evidence for increased deep neck infection risk in patients with rheumatoid arthritis

et al. 2019

Objective To investigate the association between rheumatoid arthritis (RA) and deep neck infection (DNI). Study Design Retrospective cohort study. Methods Patients newly diagnosed with RA between 2000 and 2011 were identified from the National Health Insurance Research Database in Taiwan. Moreover, patients without RA were randomly selected and matched at a 1:4 ratio by age, sex, urbanization level, income, and diabetes mellitus. The patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of DNI. Results In total, 30,207 patients with RA and 120,828 matched patients without RA were enrolled. Patients with RA had a significantly higher cumulative incidence of DNI than those without RA (P < 0.001). The adjusted Cox proportional hazard model demonstrated that RA was significantly associated with a higher incidence of DNI (hazard ratio: 2.80, 95% confidence interval: 2.26–3.46, P < 0.001). Therapeutic methods (surgical or nonsurgical) did not differ significantly between the patients with RA‐DNI and with non–RA‐DNI. Patients with RA‐DNI had higher rates of tracheostomy, mediastinitis, mediastinitis‐related mortality, and mortality than patients with non–RA‐DNI, although these differences were without statistical significance. RA patients receiving no therapy experienced higher rates of DNI compared with those receiving methotrexate alone, disease‐modifying antirheumatic drugs, or biologic therapies. Conclusion This study is the first to investigate the association between RA and DNI. We conclude RA is an independent predisposing factor for DNI. Level of Evidence 4 Laryngoscope, 130:1402–1407, 2020