Transparent Reporting on Research Using Unstructured Electronic Health Record Data to Generate ‘Real World’ Evidence of Comparative Effectiveness and Safety

AbstractResearch that makes secondary use of administrative and clinical healthcare databases is increasingly influential for regulatory, reimbursement, and other healthcare decision-making. Consequently, there are numerous guidance documents on reporting for studies that use ‘real-world’ data captured in administrative claims and electronic health record (EHR) databases. These guidance documents are intended to improve transparency, reproducibility, and the ability to evaluate validity and relevance of design and analysis decisions. However, existing guidance does n ot differentiate between structured and unstructured information contained in EHRs, registries, or other healthcare data sources. While unstructured text is convenient and readily interpretable in clinical practice, it can be difficult to use for investigation of causal questions, e.g., comparative effectiveness and safety, until data have been cleaned and algorithms applied to extract relevant information to structured fields for analysis. The goal of this paper is to increase transparency for healthcare decision makers and causal inference researchers by providing general recommendations for reporting on steps taken to make unstructured text-based data usable for comparative effectiveness and safety research. These recommendations are designed to be used as an adjunct for existing reporting guidance. They are intended to provide sufficient context and supporting information for causal inference stud...
Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research

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Conclusions: Smoking and substance abuse are common among industrial workers. Tramadol and cannabis are the most commonly abused substances. Smoking, older age, and male sex are correlates of substance abuse. Alcohol abuse is associated with dependence.
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
This study aimed to understand family communication and overall well-being of young adults in the context of familial opioid misuse using the family systems framework. Methods: A cross-sectional, mixed-methods, online survey of young adults aged 18 to 30 years (n=137) was conducted. A cluster analysis was performed based on family organization and structural characteristics. MANCOVA was utilized to compare groups identified using the cluster analysis in terms of (1) family’s belief about opioid misuse, (2) worry regarding opioid misuse, (3) family communication, and (4) overall well-being of young adults. Results...
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
Background and Aim: Controlling the symptoms of opioid withdrawal syndrome is important for the treatment of opioid addiction. There is very limited evidence on the effectiveness of pregabalin on opioid withdrawal syndrome. The present study examines the effectiveness of pregabalin in reducing opioid withdrawal symptoms. Methods: This double-blind clinical-trial was conducted on noninjecting opioid users diagnosed with opioid dependence and referred to the Addiction Treatment Center of Khorshid Hospital in Isfahan, Iran, in 2015 and 2016. The patients were divided into intervention and control groups, and both groups ...
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
This article reports an integrative review of seven trials carried out from 2007 to 2016, investigating the use of TMS on subjects abusing cocaine. The analysis was categorized into 5 different topics (1) area of intervention; (2) hemisphere; (3) number of pulses and intensity; (4) safety and adverse effects; and (5) other outcomes. Most of the trials found promising results of craving and/or use reduction with repetitive TMS (rTMS). Future interventions should consider the use of TMS as part of rehabilitation therapies.
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
Conclusions: The data were collected from school students. The statistical analysis of the Arabic version of game addiction scale for adolescents showed that the Arabic/English validity was satisfactory, with proper internal consistency and reliability.
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
Conclusions: These findings show that in Brazil problems related to alcohol use by the elderly remain relatively unknown. There was a high heterogeneity of methodologies in the studies, making it difficult to summarize the findings and produce prevalence estimates for the different patterns of consumption. More homogenous studies using similar definitions of patterns of alcohol consumption are required to allow comparisons to be made between different Brazilian regions and other countries.
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
Conclusions: A change was detected in the profile of treatment-seeking crack cocaine users over the past 2 decades. Current patients appear to be older and use the drug more chronically, in addition to having a higher level of schooling and lower unemployment rates when compared with 1997 users.
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
Objectives: For patients with opioid addiction seeking treatment, an effective option is Medication-assisted Treatment (MAT). In Albuquerque, the city with the greatest number of people who use opioids in New Mexico, the demand for MAT exceeds the number of patients receiving treatment. The authors hypothesized that a primary factor in patients’ ability to access treatment is clinic payment options, rather than the traditionally cited availability of providers. Methods: The authors conducted a survey assessing payment methods and corresponding availability in MAT programs for 53 of Albuquerque’s ~70 provid...
Source: Addictive Disorders and Their Treatment - Category: Addiction Tags: Original Articles Source Type: research
Publication date: Available online 18 November 2019Source: The Lancet PsychiatryAuthor(s): Laura E Fischer
Source: The Lancet Psychiatry - Category: Psychiatry Source Type: research
Authors: Tikka DL, Singh AR, Tikka SK PMID: 31734494 [PubMed - as supplied by publisher]
Source: Asian Journal of Psychiatry - Category: Psychiatry Tags: Asian J Psychiatr Source Type: research
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