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Who are we missing? Underrepresentation of data sources used for pharmacoepidemiology research in the United States
Author(s) -
Kaviani Pardiss,
Landi Suzanne N.,
McKethan Aaron,
Brookhart M. Alan,
McGrath Leah J.
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.5087
Subject(s) - pharmacoepidemiology , medicine , representativeness heuristic , medicaid , population , record linkage , family medicine , medline , health care , data science , environmental health , statistics , nursing , mathematics , political science , medical prescription , computer science , law , economics , economic growth
Purpose Research using healthcare databases often includes patients frequently excluded from clinical trials; yet it is not known whether commonly used data represents the overall population or specific sub‐populations of interest. We aimed to examine population representativeness from data sources in recent research studies in the United States (US). Methods We identified data sources from abstracts accepted to the 34th International Conference on Pharmacoepidemiology & Therapeutic Risk Management. The final sample included research studies using ≥1 data source from the US. We classified data sources broadly as claims, linkage, electronic health records (EHR), survey, distributed data network, and other. Studies using claims and EHRs were further classified into more specific categories, including special populations of interest (eg, children). Results We identified 356 abstracts. The majority used claims data (n = 201, 56.5%), followed by data linkages (n = 46, 12.9%), and EHR data (n = 39, 11.0%). Among EHR studies, most (n = 16, 41.0%) came from network data sources (eg, Kaiser Permanente). Almost half (49.4%) of claims‐based studies used commercial claims data sources, followed by Medicare (22.1%), Medicaid (11.3%), and Medicare Supplemental (6.1%). Only 15% of studies included children in the study population (n = 53), with 8% focused on a pediatric topic (n = 27). Conclusions We find that certain populations in the US are under‐represented in pharmacoepidemiology, particularly Medicaid enrollees and children. Researchers should strive to utilize data sources that may be more representative of the US population, particularly vulnerable populations.