Databases in Asia: the potential for distributed network approach

Abstract

BACKGROUND: One of the initial steps to establish a distributed network approach for collaborative multinational studies in Asia is to understand the applicability of a common data model (CDM) to heterogeneous data sources. However, the capacity of database in Asian countries and the feasibility to build or apply existing CDM has not been well described. OBJECTIVES: To describe database availability and characteristics of the databases in Asian countries and to assess the feasibility to apply a CDM in Asian database environments. METHODS: A web-based survey was conducted among investigators using healthcare databases in Asia. The potential survey participants were identified through the Asian Pharmacoepidemiology Network. The survey included questions: 1) characteristics of database, 2) patients demographics, 3) data components and coding system 4) medical expenditure, and 5) the traditional Chinese medicine (TCM) or complementary medicine. RESULTS: A total of 10 data sources from Asian countries participated in the survey, including nationwide databases form Japan, Korea, Taiwan, and Hong Kong. These contained data on approximately 128, 50, 23, and 7 million individuals, respectively, covering all age groups and the majority was Asian. One claims database includes all veterans and dependents (approximately 330,000 individuals) from Australia with predominantly elderly and Caucasian. Others included a hospital based EHR from China (5 million individuals) and two EHRs from Thailand (1 million and 300,000 individuals). Two registries for cancer and stroke were from Taiwan. The majority of databases possesses diagnoses information with the date by either ICD9 or ICD10 codes; and encompasses procedures and prescriptions records with the date by domestic coding systems. Three databases contain dispensing data for TCMs. One EHR includes information of Thai herbal medicine. CONCLUSIONS: There are numerous Asian databases with comprehensive healthcare information to provide an opportunity for applying distributed network approach in Asia. Harmonization of the coding systems as well as understanding practice patterns affecting the interpretation of results will be challenges for multinational database studies.