SynthesisProceedings of the National Academy of Sciences of the United States of America2016
Characterizing treatment pathways at scale using the OHDSI network.
Synthesis in Proceedings of the National Academy of Sciences of the United States of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 177 papers, 3 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
177 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Common data models and data standards for tabular health data: a systematic review.BMC medical informatics and decision making · 2025Pooled it
- Pharmacoepidemiologic Research Based on Common Data Models: Systematic Review and Bibliometric Analysis.JMIR medical informatics · 2025Pooled it
- Secondary use of health records for prediction, detection, and treatment planning in the clinical decision support system: a systematic review.BMC medical informatics and decision making · 2025Pooled it
- Estimating Risk Differences Using Large Healthcare Data Networks for Medical Product Post-Market Safety Outcomes in a Distributed Data Setting and Allowing for Active Post-Market Surveillance.Statistics in medicine · 2026Article
- Preparing real-world data through common data model harmonization of cancer patient records in the COMNet platform at the Modena Oncology Center.Frontiers in digital health · 2026Article
- Treatment sequence patterns of urate-lowering therapy in Korean patients with gout: A common data model-based study.PloS one · 2026Article
- Individualized treatment rule for early steroid use in hospitalized patients with community acquired pneumonia: a cohort study.Pneumonia (Nathan Qld.) · 2025Article
- Leveraging Multi-National Observational Study in Post-Marketing Safety Assessment: Challenges and Strategies.Therapeutic innovation & regulatory science · 2025Article
- Visualizing Real-World Pain Treatment Pathways in Chronic Disease: A Sequence-Based Analysis of Polypharmacy in Systemic Lupus Erythematosus.ACR open rheumatology · 2025Article
- Unlocking efficiency in real-world collaborative studies: a multi-site international study with one-shot lossless GLMM algorithm.NPJ digital medicine · 2025Article
- Bridging the Regulatory Divide: A Dual-Pathway Framework Using SRA Approvals and AI Evaluation to Ensure Drug Quality in Developing Countries.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Drug combination-wide association studies of cancer.Communications medicine · 2025Article
- Computational Phenomapping of Randomized Clinical Trial Participants to Enable Assessment of Their Real-World Representativeness and Personalized Inference.Circulation. Cardiovascular quality and outcomes · 2025Article
- Uncertainty Quantification for Clinical Outcome Predictions with (Large) Language Models.Findings of ACL. NAACL · 2025Article
- Federated Adaptive Causal Estimation (FACE) of Target Treatment Effects.Journal of the American Statistical Association · 2025Article
- Mapping Emergency Medicine Data to the Observational Medical Outcomes Partnership Common Data Model: A Gap Analysis of the American College of Emergency Physicians Clinical Emergency Data Registry.Journal of the American College of Emergency Physicians open · 2025Article
- Article
- Rapid identification and phenotyping of nonalcoholic fatty liver disease patients using a machine-based approach in diverse healthcare systems.Clinical and translational science · 2025Article
- The challenges of national health data ecosystems in feeding the European health data space: the Italian example.Frontiers in medicine · 2025Article
- Article
117 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
17 authors.
Funding
Abstract
Observational research promises to complement experimental research by providing large, diverse populations that would be infeasible for an experiment. Observational research can test its own clinical hypotheses, and observational studies also can contribute to the design of experiments and inform the generalizability of experimental research. Understanding the diversity of populations and the variance in care is one component. In this study, the Observational Health Data Sciences and Informatics (OHDSI) collaboration created an international data network with 11 data sources from four countries, including electronic health records and administrative claims data on 250 million patients. All data were mapped to common data standards, patient privacy was maintained by using a distributed model, and results were aggregated centrally. Treatment pathways were elucidated for type 2 diabetes mellitus, hypertension, and depression. The pathways revealed that the world is moving toward more consistent therapy over time across diseases and across locations, but significant heterogeneity remains among sources, pointing to challenges in generalizing clinical trial results. Diabetes favored a single first-line medication, metformin, to a much greater extent than hypertension or depression. About 10% of diabetes and depression patients and almost 25% of hypertension patients followed a treatment pathway that was unique within the cohort. Aside from factors such as sample size and underlying population (academic medical center versus general population), electronic health records data and administrative claims data revealed similar results. Large-scale international observational research is feasible.
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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.