SynthesisBMJ (Clinical research ed.)2009
Use of primary care electronic medical record database in drug efficacy research on cardiovascular outcomes: comparison of database and randomised controlled trial findings.
Synthesis in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01141439 (A Retrospective Evaluation of the Effectiveness and Cost-effectiveness of HFA-BDP MDI), which is not on this map. Cited by 62 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Retrospective Evaluation of the Effectiveness and Cost-effectiveness of HFA-BDP MDI (Qvar®) Compared With CFC-BDP MDI and FP MDI Used in the Management of Asthma in a Representative UK UK Primary Care Population
Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it, 144 citations in OpenAlex.
- Data quality assessment in healthcare, dimensions, methods and tools: a systematic review.BMC medical informatics and decision making · 2025Pooled it
- Strategy to Control Biases in Prior Event Rate Ratio Method, With Application to Palliative Care in Patients With Advanced Cancer.Statistics in medicine · 2026Article
- Overcoming data challenges through enriched validation and targeted sampling to measure whole-person health in electronic health records.Journal of biomedical informatics · 2025Article
- Long-Term Effectiveness of Acetylsalicylic Acid in Primary Prevention of Cardiovascular Diseases and Mortality in Patients at High Risk, a Retrospective Cohort Study-The JOANA Study.Journal of clinical medicine · 2025Article
- Reverse Time-to-Death as Time-Scale in Time-to-Event Analysis for Studies of Advanced Illness and Palliative Care.Statistics in medicine · 2025Article
- Two assumptions of the prior event rate ratio approach for controlling confounding can be evaluated by self-controlled case series and dynamic random intercept modeling.Journal of clinical epidemiology · 2024Article
- Development and Implementation of a Dynamically Updated Big Data Intelligence Platform Using Electronic Medical Records for Secondary Hypertension.Reviews in cardiovascular medicine · 2024Article
- Use of Bisphosphonates and the Risk of Skin Ulcer: A National Cohort Study Using Data from the French Health Care Claims Database.Drug safety · 2023Article
- Healthcare systems data in the context of clinical trials - A comparison of cardiovascular data from a clinical trial dataset with routinely collected data.Contemporary clinical trials · 2023Article
- Observational
- Real-world effectiveness of pneumococcal vaccination in older adults: Cohort study using the UK Clinical Practice Research Datalink.PloS one · 2022Article
- A cost-effective chart review sampling design to account for phenotyping error in electronic health records (EHR) data.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- The Effect of Buprenorphine on Human Immunodeficiency Virus Viral Suppression.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Economic Assessment of High-Dose Versus Adjuvanted Influenza Vaccine: An Evaluation of Hospitalization Costs Based on a Cohort Study.Vaccines · 2021Article
- On the Causal Interpretation of Rate-Change Methods: The Prior Event Rate Ratio and Rate Difference.American journal of epidemiology · 2021Article
- Rivaroxaban was found to be noninferior to warfarin in routine clinical care: A retrospective noninferiority cohort replication study.Pharmacoepidemiology and drug safety · 2020Article
- Prior event rate ratio adjustment produced estimates consistent with randomized trial: a diabetes case study.Journal of clinical epidemiology · 2020Article
- Assessing the prior event rate ratio method via probabilistic bias analysis on a Bayesian network.Statistics in medicine · 2020Article
- Advantages of large medical record database for outcomes research: Insights into post-menopausal hormone therapy.Learning health systems · 2019Article
- Effectiveness of Statins as Primary Prevention in People With Different Cardiovascular Risk: A Population-Based Cohort Study.Clinical pharmacology and therapeutics · 2018Observational
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo determine whether observational studies that use an electronic medical record database can provide valid results of therapeutic effectiveness and to develop new methods to enhance validity.
designData from the UK general practice research database (GPRD) were used to replicate previously performed randomised controlled trials, to the extent that was feasible aside from randomisation. Studies Six published randomised controlled trials.
main outcome measureCardiovascular outcomes analysed by hazard ratios calculated with standard biostatistical methods and a new analytical technique, prior event rate ratio (PERR) adjustment.
resultsIn nine of 17 outcome comparisons, there were no significant differences between results of randomised controlled trials and database studies analysed using standard biostatistical methods or PERR analysis. In eight comparisons, Cox adjusted hazard ratios in the database differed significantly from the results of the randomised controlled trials, suggesting unmeasured confounding. In seven of these eight, PERR adjusted hazard ratios differed significantly from Cox adjusted hazard ratios, whereas in five they didn't differ significantly, and in three were more similar to the hazard ratio from the randomised controlled trial, yielding PERR results more similar to the randomised controlled trial than Cox (P<0.05).
conclusionsAlthough observational studies using databases are subject to unmeasured confounding, our new analytical technique (PERR), applied here to cardiovascular outcomes, worked well to identify and reduce the effects of such confounding. These results suggest that electronic medical record databases can be useful to investigate therapeutic effectiveness.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.