title: Comparative effectiveness research with administrative health data in rheumatoid arthritis.
abstract: Comparative effectiveness research (CER) enables the comparison of different treatments in the real-world setting to inform clinical decision-making. Rheumatoid arthritis (RA) has been identified as a high priority area for CER. Administrative health databases, which generally consist of physician billing claims, hospital discharge summaries and prescription drug records, have been widely used to conduct observational research in RA. These data are accurate and complete records of health-care use unaffected by recall bias, and provide large, general population samples and information on long-term follow-up. However, administrative health data pose unique methodological challenges for CER in the field of RA. Here, we discuss the challenges of studying treatment effectiveness with CER (as distinct from harms and costs), in particular, issues relating to the identification and definition of RA cases, timing of disease onset and determination of disease severity. We also discuss an algorithm developed to measure effectiveness outcomes of RA treatments in administrative data, and potential sources of bias that might affect the validity of results. Finally, we explore opportunities for use of administrative data in CER, such as comparisons between reference drugs and biosimilars.
authors.affiliation: Division of Rheumatology, Lady Davis Institute, Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, Quebec H3T 1E2, Canada.|Division of Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, Quebec H3T 1E2, Canada.|Department of Medicine, McGill University Health Center, 1001 Decarie Boulevard, Suite D05-2212, Montreal, Quebec H4A 3J1, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Hudson
authors.affiliation: Division of Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, Quebec H3T 1E2, Canada.
authors.forename: Koray
authors.initials: K
authors.lastname: Tascilar
authors.affiliation: Division of Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, Quebec H3T 1E2, Canada.|Department of Medicine, McGill University Health Center, 1001 Decarie Boulevard, Suite D05-2212, Montreal, Quebec H4A 3J1, Canada.
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use; D059451:Biosimilar Pharmaceuticals / Q000627:therapeutic use; D057186:Comparative Effectiveness Research / Q000379:methods*; D016208:Databases, Factual; D011307:Drug Prescriptions; D006801:Humans; D063886:Patient Discharge Summaries; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D059451:Biosimilar Pharmaceuticals