Article(id=1195741158950351578, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1195741158056964822, articleNumber=1001-2494(2024)04-0369-06, orderNo=null, doi=10.11669/cpj.2024.04.011, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1665676800000, receivedDateStr=2022-10-14, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1763016508090, onlineDateStr=2025-11-13, pubDate=1708531200000, pubDateStr=2024-02-22, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763016508090, onlineIssueDateStr=2025-11-13, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763016508090, creator=13701087609, updateTime=1763016508090, updator=13701087609, issue=Issue{id=1195741158056964822, tenantId=1146029695717560320, journalId=1190317699101192196, year='2024', volume='59', issue='4', pageStart='285', pageEnd='374', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1763016507876, creator=13701087609, updateTime=1763016622263, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1195741637893730663, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1195741158056964822, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1195741637893730664, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1195741158056964822, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=369, endPage=374, ext={EN=ArticleExt(id=1195741159206204126, articleId=1195741158950351578, tenantId=1146029695717560320, journalId=1190317699101192196, language=EN, title=Discussion and Work Experience Sharing of Real-World Data Quality Control in the Clinical Comprehensive Evaluation of Drugs, columnId=null, journalTitle=Chinese Pharmaceutical Journal, columnName=null, runingTitle=null, highlight=null, articleAbstract=

OBJECTIVE To explore the quality control of real-world data in the drug clinical comprehensive evaluation, and promote the scientific and rational application of real-world data in the drug comprehensive clinical evaluation. METHODS Literature on the quality control of real-world research data in drug clinical comprehensive evaluation was reviewed, and the work experience of the drug clinical comprehensive evaluation center in the province where the author is located was integrated to explore the content and process of quality control of real-world research data in drug clinical comprehensive evaluation. RESULTS AND CONCLUSION Quality control of real-world research data generally includes internal and external controls. Evaluation methods comprise qualitative assessment, quantitative assessment, and comprehensive assessment. The implementation phase can be divided into the project initiation phase and the data governance phase, with a round of data quality control conducted in each phase. This study summarizes the content and process of quality control for real-world research data in the drug clinical comprehensive evaluation, providing a reference for researchers and decision-makers to correctly produce and use evidence from real-world data for drug clinical comprehensive evaluation.

, correspAuthors=ZUO Xiaocong, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=YIN Wenjun, XIE Yueliang, HUANG Yujie, PIAO Huiling, ZUO Xiaocong), CN=ArticleExt(id=1195741199580574449, articleId=1195741158950351578, tenantId=1146029695717560320, journalId=1190317699101192196, language=CN, title=药品临床综合评价中真实世界数据质量控制的探讨和工作经验分享, columnId=1190352405612040510, journalTitle=中国药学杂志, columnName=论著, runingTitle=null, highlight=null, articleAbstract=

目的 探索药品临床综合评价中真实世界数据的质量控制,推动真实世界数据在药品临床综合评价中科学合理地应用。方法 查阅国内外药品临床综合评价真实世界研究数据质量控制的文献,并结合笔者所在省份的药品临床综合评价中心开展的工作经验,探讨药品临床综合评价真实世界研究数据质量控制的内容和流程。结果与结论 真实世界研究数据质量控制一般分为内部质控和外部质控,评价方法包括定性评价,定量评价和综合评价,实施阶段可分为项目启动阶段和数据治理后阶段,并在这两阶段各开展一次数据质量控制。本研究归纳总结了药品临床综合评价真实世界研究数据质量控制的内容和流程,为研究者和决策者正确生产和使用基于真实世界数据药品临床综合评价证据提供参考。

, correspAuthors=左笑丛, authorNote=null, correspAuthorsNote=
*左笑丛,女,主任药师 研究方向:个体化用药,肾脏药理,药品临床综合评价 Tel:(0731)88618455
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尹文俊,男,主管药师 研究方向:合理用药大数据,药品临床综合评价

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Chin Acupunc Moxib(中国针灸), 2020, 40(7):773-775., articleTitle=Preliminary study on the quality control method and content of acupuncture registration, refAbstract=null), Reference(id=1197101593779810742, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1195741158950351578, doi=null, pmid=null, pmcid=null, year=2022, volume=43, issue=1, pageStart=9, pageEnd=15, url=null, language=null, rfNumber=[42], rfOrder=41, authorNames=ZHANG L X, SUN H X, TANG M K, journalName=J Med Inf(医学信息学杂志), refType=null, unstructuredReference=ZHANG L X, SUN H X, TANG M K, et al. Review of real world electronic medical record data evaluation[J]. J Med Inf(医学信息学杂志), 2022, 43(1):9-15., articleTitle=Review of real world electronic medical record data evaluation, refAbstract=null), Reference(id=1197101593834336695, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1195741158950351578, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=https://www.nmpa.gov.cn/xxgk/ggtg/qtggtg/20160729183801891.html, language=null, rfNumber=[43], rfOrder=42, authorNames=National Medical Products Administration, journalName=null, refType=null, unstructuredReference=National Medical Products Administration. Circular of the General Administration on Issuing Technical Guidelines for the Management of Clinical Trial Data (No. 112 of 2016)[EB/OL]. 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作者 年份/年 研究目的 维度指标
Cui[22] 2020 通过分析精准医疗大数据的质控现状,构建了三阶段质量控制体系,从而提升数据质量 完整性、真实性、规范性、一致性、准确性、唯一性、安全性、可用性和价值性
Yu[4] 2022 总结各国家、国际组织真实世界数据适用性文件,对真实世界数据适用性的概念、范畴、评价维度、指标细则、评价方式及已开展研究进行梳理归纳,探讨我国开展真实世界数据适用性评价所面临的机遇和挑战 准确性、可比较性、一致性、完整性、相关性、可及性、合理性、时效性、可解释性、修正度和互联互通性
Wang[33] 2018 帮助行业加强对数据集质量管理的重视,通过对其质量管理体系的科学管理,确保和提升人工智能医疗器械产品质量 真实性、完整性、可用性、合规性、可追溯性、临床代表性、时效性、安全性和一致性
Mo[34] 2017 分析大数据处理中的每个环节,构建数据处理全过程的质量影响模型,以改善大数据质量 真实性、完整性、一致性、准确性、时效性、安全性、可用性、价值性和易于理解性
Ma[35] 2016 通过分析现有的数据质量评价维度,建立质量评价体系,从而为政府大数据的管理提供参考 准确性、时效性、相关性、客观性、可衔接性、完整性、可理解性、透明性、可操作性、可取得性、可解释性、效益性和安全性
Cai[36] 2018 依据已有的数据质量研究的成果,探讨了当前环境下数据质量研究的发展方向,为提高数据质量做出贡献 准确性、可获得性、完整性、一致性和及时性
Qiao[37] 2022 为充分利用孤儿药真实世界数据,对真实世界研究应用于孤儿药的方法学进行综述,为我国开展相关研究提供参考 相关性、代表性、完整性、准确性、一致性、真实性和可重复性
Liaw[38] 2021 试图完成关于数据质量评估框架、指标和工具的文献综述,用以研究整个数据生命周期,改进公共卫生、服务和质量 可访问性、可重用性、及时性、可靠性、相关性、可追溯性和互操作性
Abuhalimeh[39] 2022 提出维护不同系统之间数据质量的步骤/规则,以帮助医疗保健组织的数据治理 准确性、完整性、一致性、及时性、有效性和可理解性
), ArticleFig(id=1197101589786833286, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1195741158950351578, language=CN, label=表1, caption=

归纳部分文献中涵盖的真实世界数据评价维度指标

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作者 年份/年 研究目的 维度指标
Cui[22] 2020 通过分析精准医疗大数据的质控现状,构建了三阶段质量控制体系,从而提升数据质量 完整性、真实性、规范性、一致性、准确性、唯一性、安全性、可用性和价值性
Yu[4] 2022 总结各国家、国际组织真实世界数据适用性文件,对真实世界数据适用性的概念、范畴、评价维度、指标细则、评价方式及已开展研究进行梳理归纳,探讨我国开展真实世界数据适用性评价所面临的机遇和挑战 准确性、可比较性、一致性、完整性、相关性、可及性、合理性、时效性、可解释性、修正度和互联互通性
Wang[33] 2018 帮助行业加强对数据集质量管理的重视,通过对其质量管理体系的科学管理,确保和提升人工智能医疗器械产品质量 真实性、完整性、可用性、合规性、可追溯性、临床代表性、时效性、安全性和一致性
Mo[34] 2017 分析大数据处理中的每个环节,构建数据处理全过程的质量影响模型,以改善大数据质量 真实性、完整性、一致性、准确性、时效性、安全性、可用性、价值性和易于理解性
Ma[35] 2016 通过分析现有的数据质量评价维度,建立质量评价体系,从而为政府大数据的管理提供参考 准确性、时效性、相关性、客观性、可衔接性、完整性、可理解性、透明性、可操作性、可取得性、可解释性、效益性和安全性
Cai[36] 2018 依据已有的数据质量研究的成果,探讨了当前环境下数据质量研究的发展方向,为提高数据质量做出贡献 准确性、可获得性、完整性、一致性和及时性
Qiao[37] 2022 为充分利用孤儿药真实世界数据,对真实世界研究应用于孤儿药的方法学进行综述,为我国开展相关研究提供参考 相关性、代表性、完整性、准确性、一致性、真实性和可重复性
Liaw[38] 2021 试图完成关于数据质量评估框架、指标和工具的文献综述,用以研究整个数据生命周期,改进公共卫生、服务和质量 可访问性、可重用性、及时性、可靠性、相关性、可追溯性和互操作性
Abuhalimeh[39] 2022 提出维护不同系统之间数据质量的步骤/规则,以帮助医疗保健组织的数据治理 准确性、完整性、一致性、及时性、有效性和可理解性
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维度 定义
可及性 在研究期限内数据库应是连续的、处于活动状态的,所记录的数据均是可及的,即具有数据的使用权限(可搜索度、可阅读、可下载、可编辑程度及数据获取成本),并且可被医疗机构药品临床综合评价机构评估
相关性 真实世界数据来源类型多样,不同的研究目的、研究设计以及分析方法所需的数据类型不同,应根据具体情况选择真实世界来源的数据。真实世界数据是否可用于研究问题的分析,是否与研究相关
信息覆盖度 真实世界数据应包含与临床结局相关的重要变量和信息,如药品的使用、患者人口学和临床特征、协变量、结局变量、暴露/干预变量、随访时间、潜在安全性信息等
代表性 真实世界研究较传统随机对照试验的优势之一是具有更广泛的目标人群的代表性。因此,在制定纳入和排除标准时,应尽可能地符合真实世界环境下目标人群
样本量 应考虑是否有足够的有效样本量以证明疗效,并获取充分的潜在安全性事件。同时预判经数据治理后在源数据例数明显减少的情况,仍能保证统计分析所需的样本量
时效性 从数据生成、存储到使用之间的有效期,超出时间范围则预测结果无价值。要定义数据发挥价值的有效期和更新周期
安全性 数据源所在平台要确保数据安全,保护患者隐私,防止数据的缺失与泄露,对数据的权限与访问都要控制
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真实世界数据初步适应性评估维度和定义[4,33-35,40]

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维度 定义
可及性 在研究期限内数据库应是连续的、处于活动状态的,所记录的数据均是可及的,即具有数据的使用权限(可搜索度、可阅读、可下载、可编辑程度及数据获取成本),并且可被医疗机构药品临床综合评价机构评估
相关性 真实世界数据来源类型多样,不同的研究目的、研究设计以及分析方法所需的数据类型不同,应根据具体情况选择真实世界来源的数据。真实世界数据是否可用于研究问题的分析,是否与研究相关
信息覆盖度 真实世界数据应包含与临床结局相关的重要变量和信息,如药品的使用、患者人口学和临床特征、协变量、结局变量、暴露/干预变量、随访时间、潜在安全性信息等
代表性 真实世界研究较传统随机对照试验的优势之一是具有更广泛的目标人群的代表性。因此,在制定纳入和排除标准时,应尽可能地符合真实世界环境下目标人群
样本量 应考虑是否有足够的有效样本量以证明疗效,并获取充分的潜在安全性事件。同时预判经数据治理后在源数据例数明显减少的情况,仍能保证统计分析所需的样本量
时效性 从数据生成、存储到使用之间的有效期,超出时间范围则预测结果无价值。要定义数据发挥价值的有效期和更新周期
安全性 数据源所在平台要确保数据安全,保护患者隐私,防止数据的缺失与泄露,对数据的权限与访问都要控制
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药品临床综合评价中真实世界数据质量控制的探讨和工作经验分享
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尹文俊 , 谢悦良 , 黄玉洁 , 朴慧玲 , 左笑丛 *
中国药学杂志 | 论著 2024,59(4): 369-374
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中国药学杂志 | 论著 2024, 59(4): 369-374
药品临床综合评价中真实世界数据质量控制的探讨和工作经验分享
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尹文俊, 谢悦良, 黄玉洁, 朴慧玲, 左笑丛*
作者信息
  • 中南大学湘雅三医院, 长沙 410013
  • 尹文俊,男,主管药师 研究方向:合理用药大数据,药品临床综合评价

通讯作者:

*左笑丛,女,主任药师 研究方向:个体化用药,肾脏药理,药品临床综合评价 Tel:(0731)88618455
Discussion and Work Experience Sharing of Real-World Data Quality Control in the Clinical Comprehensive Evaluation of Drugs
YIN Wenjun, XIE Yueliang, HUANG Yujie, PIAO Huiling, ZUO Xiaocong*
Affiliations
  • The Third Xiangya Hospital of Central South University, Changsha 410013, China
出版时间: 2024-02-22 doi: 10.11669/cpj.2024.04.011
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目的 探索药品临床综合评价中真实世界数据的质量控制,推动真实世界数据在药品临床综合评价中科学合理地应用。方法 查阅国内外药品临床综合评价真实世界研究数据质量控制的文献,并结合笔者所在省份的药品临床综合评价中心开展的工作经验,探讨药品临床综合评价真实世界研究数据质量控制的内容和流程。结果与结论 真实世界研究数据质量控制一般分为内部质控和外部质控,评价方法包括定性评价,定量评价和综合评价,实施阶段可分为项目启动阶段和数据治理后阶段,并在这两阶段各开展一次数据质量控制。本研究归纳总结了药品临床综合评价真实世界研究数据质量控制的内容和流程,为研究者和决策者正确生产和使用基于真实世界数据药品临床综合评价证据提供参考。

药品临床综合评价  /  真实世界数据  /  质量控制

OBJECTIVE To explore the quality control of real-world data in the drug clinical comprehensive evaluation, and promote the scientific and rational application of real-world data in the drug comprehensive clinical evaluation. METHODS Literature on the quality control of real-world research data in drug clinical comprehensive evaluation was reviewed, and the work experience of the drug clinical comprehensive evaluation center in the province where the author is located was integrated to explore the content and process of quality control of real-world research data in drug clinical comprehensive evaluation. RESULTS AND CONCLUSION Quality control of real-world research data generally includes internal and external controls. Evaluation methods comprise qualitative assessment, quantitative assessment, and comprehensive assessment. The implementation phase can be divided into the project initiation phase and the data governance phase, with a round of data quality control conducted in each phase. This study summarizes the content and process of quality control for real-world research data in the drug clinical comprehensive evaluation, providing a reference for researchers and decision-makers to correctly produce and use evidence from real-world data for drug clinical comprehensive evaluation.

drug clinical comprehensive evaluation  /  real-world data  /  quality control
尹文俊, 谢悦良, 黄玉洁, 朴慧玲, 左笑丛. 药品临床综合评价中真实世界数据质量控制的探讨和工作经验分享. 中国药学杂志, 2024 , 59 (4) : 369 -374 . DOI: 10.11669/cpj.2024.04.011
YIN Wenjun, XIE Yueliang, HUANG Yujie, PIAO Huiling, ZUO Xiaocong. Discussion and Work Experience Sharing of Real-World Data Quality Control in the Clinical Comprehensive Evaluation of Drugs[J]. Chinese Pharmaceutical Journal, 2024 , 59 (4) : 369 -374 . DOI: 10.11669/cpj.2024.04.011
药品临床综合评价是指以药品回归临床价值为导向应用多种方法和工具对药品的有效性、安全性、经济性等作出的综合研判,为巩固完善基本药物制度、健全药品供应保障制度和促进医疗机构合理用药提供参考依据[1-3]。真实世界数据是开展药品临床综合评价的重要支撑,具体是指在患者诊疗过程中产生的与健康状况相关的数据,包括医疗卫生机构卫生信息系统数据、出生死亡及疾病登记系统数据和药品不良反应监测数据等[1,4-9]。目前来源不同的真实世界数据质量参差不齐,如何评价用于药品临床综合评价的真实世界数据质量,如何评估所收集的真实世界数据是否可以产生高质量的真实世界证据,是利用真实世界数据开展药品临床综合评价的关键。
提高真实世界数据的质量,开展数据质量控制,对规范、科学、合理地设计并实施药品临床综合评价研究,推动真实世界数据在药品临床综合评价中的使用并发挥其优势具有非常重要的理论和现实意义。因此要对数据治理的各个环节进行质量控制[1,10-12]。国家卫生健康委办公厅《关于规范开展药品临床综合评价工作的通知》(国卫办药政发〔2021〕16号)明确对数据可靠性等要进行核查,国家药品监督管理局颁布的2020《指导原则》[13]和《用于产生真实世界证据的真实世界数据指导原则(试行)》(2021《指导原则》[14]中对真实世界数据适用性做了明确指导和规范。因此,本研究就国内外药品临床综合评价真实世界研究数据质量控制的文献进行归纳总结,并结合笔者所在省份的药品临床综合评价中心开展的工作经验,进一步探讨真实世界研究数据质量控制的内容和流程。
根据开展数据质量控制的主体不同,Zhao等[15]认为数据质量控制可分为内部质控和外部质控,内部质控由评价主体建立内部质控小组实施,目前我国药品临床综合评价主要由医疗卫生机构牵头开展,《药品临床综合评价管理指南》明确医疗卫生机构及其医生、药师等专业技术人员是药品临床综合评价的质量控制主体;外部质控一般由省级综合评价中心组建质控专家组承担。笔者所在省级综合评价质控中心制定了《湖南省药品临床综合评价专家遴选办法》,遴选组建了包括临床医学、临床药学、循证医学、医学伦理学、流行病与卫生统计学、卫生技术评估、药物经济学、卫生管理、卫生政策、医疗保险、卫生信息、卫生法学等方面的专家库,根据项目随机抽取专家组建项目质控专家组,负责项目启动阶段的数据质量评价。
目前关于真实世界研究数据质量评价方法的研究还比较少,主要是通用性数据质量评价方法,包括定性评价,定量评价和综合评价[16-18]。定性评价是指不采用数学分析方法,根据专家经验对数据作出的评价;定量评价是指采用数学分析方法,计算事先制定的客观指标对数据进行评价;综合评价是将定性评价和定量评价相结合,通常是在定性评价的基础上引入定量分析的客观指标,例如德尔菲专家法[19-21]
药品临床综合评价中的数据质量控制贯穿整个研究,分不同的实施阶段。在2021《指导原则》中将真实世界数据的适用性评价分为两个阶段,第一阶段是对源数据进行初步评价和选择,判断其可否用于相关研究;第二阶段是对治理后的数据评价是否适用于产生真实世界证据[14]。Cui等[22]根据数据处理的时间分别进行质量控制。事前控制主要是在数据处理前制定数据质控标准;事中控制主要是对数据处理各个环节的质量控制;事后控制是指对之前进行的数据处理过程进行评价并提出改善方法[22]。这里的数据指的是通用性数据,但也同样适用于真实世界研究数据。本研究将药品临床综合评价数据质量控制分为项目启动阶段和数据治理后阶段,并总结了两个阶段数据质量控制的内容。
项目启动阶段包括项目管理层面的数据质量控制和技术规范层面的数据质量控制。项目管理层面的数据质量控制包括数据管理人员资质审查和伦理批件等。技术规范层面的数据质量控制包括数据治理计划、标准操作流程和数据初步适应性评价。
项目管理层面:①数据管理人员:数据管理人员需要通过数据管理方面的专业培训[23-25],包括:数据的合理性;临床研究数据文档标准;数据监管的法律政策;标准操作流程(SOP);行业规范;数据管理系统的相关操作技术和数据安全性培训等。②伦理审查[26-28]:在使用真实世界数据前,须获得伦理批件。由伦理委员会审查批准后方可开展药品临床综合评价。
技术规范层面:①数据治理计划:药品临床综合评价的数据治理计划应在真实世界数据获取前制定,数据治理计划应包括:研究目的、设计方案、真实世界数据的来源、数据标准、数据提取和清洗方法、缺失数据的处理方法、数据治理流程和团队的分工等[14,29],由质控专家组评估其合理性;②标准操作流程:事先制定完善的标准操作流程,以保障数据质量。一般来说,数据管理的SOP[30-31]包括以下内容:数据库的建立;逻辑验证;数据的治理与管理;医学信息标准文件;数据的保存与归档;数据的安全性;人员培训等。质控专家组应对其进行可行性评估;③数据初适应性评估:是指评价真实世界数据能否满足使用者需求[13,32],在药品临床综合评价获取真实世界研究数据之前也就是项目启动阶段开展。目前少有文献区分项目启动阶段和数据治理后阶段质量控制的维度指标,通常是整个研究周期中数据质量控制的维度指标。2021《指导原则》中是将质量控制分为两个阶段。Yu等[4]梳理主要国际组织和典型国家最新的相关文件,归纳12个通用的真实世界数据适用性维度指标。
此外,还有学者对精准医疗的大数据质量控制、人工智能医疗器械用数据集管理与评价方法等进行了研究[33],各研究涵盖的维度指标总结见表1。值得注意的是,在Cui等[22]对精准医疗的大数据质量控制研究中,将数据处理分为数据采集、数据预处理、数据存储、数据分析和数据呈现与应用5个步骤,提出在不同步骤采用不同的评价维度指标。
本研究根据目前已发表的文献和指南性文件,归纳总结可及性、相关性、信息覆盖度、代表性、样本量、时效性和安全性7个维度作为常用的项目启动阶段质量控制维度指标(表2)。其中,可及性、相关性和安全性是高频次维度,在多数文献和文件中被纳入,而时效性、代表性、样本量、信息覆盖度还未受到足够的重视。归纳完整性、准确性、一致性、真实性、可溯源性和安全性作为常用的数据治理后阶段质量控制维度指标。
数据治理是指数据使用者根据项目研究计划获得源数据后,再根据数据治理计划对源数据进行整治,数据治理包括缺失值、错误数据的处理等。治理后的数据是可以直接用于药品临床综合评价,也是数据质量控制工作的重点对象。本研究根据目前已发表的文献和指南性文件,归纳治理后数据质量控制包括六个维度指标[4,22,33-42],分别是完整性、准确性、一致性、真实性、可溯源性和安全性。
完整性:完整性是指数据的所有信息必须是完整的,不能有缺失。对于数据量小的数据可以全数据集检查,对于数据量大的数据可通过抽样进行检查,并重点关注关键变量。在数据治理计划中应明确数据缺失比例预期值,当数据的缺失比例超过预期值,应当慎重考虑该数据是否可以用于药品临床综合评价。对于缺失比例在预期值内的数据,应根据数据缺失情况选择合适的填补方法。
准确性:准确性是指数据与其描述的客观特征是否一致。准确性最重要的是要核实治理后的数据与源数据是否一致,首先从整体上对数据进行核查,对于极端值和超过生理正常变化范围之外的数据进行核查,例如身高为1731cm;对出现不符合正常逻辑的病例进行核查,例如男性患者患宫腔疾病。其次,对病例要进行抽样核查,在《临床试验数据管理工作技术指南(2016年)》[43]对数据核查做了具体要求,关键指标要对数据库100%的复查,其余指标根据总病例数复查,大于100例,随机抽取1%~10%进行复查,小于100,则对病例数开平方进行复查。核查过程中的错误率有一定标准,超过此标准需进行100%核对。
一致性:一致性是指同一数据库/源内部,同一指标数据在不同时点重复测量后结果的一致程度;不同指标数据之间的数据关联合理程度。药品临床综合评价的数据通常是多来源的,不同数据来源单位或同一单位不同实验室的检测同一指标的采用的方法和标准可能不一致,对同一疾病的诊断标准存在差异。数据采集过程中,为保障数据一致性,要有统一的数据标准和格式。
真实性:真实性是指使用的数据应当是真实可信的,并有据可循,不能对数据进行“修饰”,所有数据都要有原始记录、审核记录以及相关证据链佐证。
可溯源性:在数据治理过程中,对于存疑的数据通常可能需要修改,对于录入过程中的任何修改,需要有负责人的确认和签名,并提供修改原因,确保留下完整的稽查轨迹,数据质量控制过程需对稽查记录进行抽查。
安全性:数据安全性应基于研究所涉及的各种数据的类型、数量、性质和内容,尤其对于个人敏感信息,确保数据治理各环节的数据加密技术要求、风险评估和应急处置操作规程,以文件形式记录脱敏、网络安全、物理隔离等关键措施,并开展安全措施有效性审计。
质控专家组根据药品临床综合评价数据质控具体内容对项目开展质量控制,质控专家组包括项目组建的内部质控专家组,也包括省级综合评价中心组建的外部质控专家组。笔者根据文献资料总结和笔者所在省份的质控中心经验归纳了真实世界研究数据质量控制的流程,一般情况下开展两次数据质量控制,分别为项目启动阶段和数据治理后阶段,质控专家组可根据项目实际情况增加质控次数,见图1。质控专家组在质控中要有反馈意见,并填写质控检查表,交由质控组组长保存,项目负责人收到反馈以后,对项目存在的问题进行整改并回复反馈意见,质控专家组对整改结果进行审查,通过则进入下一个阶段,否则继续整改或终止项目,项目结束时,要进行药物临床综合评价项目质控总结,把缺失的内容或材料补齐。
  • 湖南省医学会科研基金-临床药学项目资助(HMA202001003)
  • 药源性器官损伤智能防控湖南省工程研究中心
  • 湖南省药学会科研基金资助(2020YXH010)
  • 基于真实世界数据的区域内药品临床综合评价质控体系构建研究(国家卫生健康委卫生发展研究中心)
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2024年第59卷第4期
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doi: 10.11669/cpj.2024.04.011
  • 接收时间:2022-10-14
  • 首发时间:2025-11-13
  • 出版时间:2024-02-22
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  • 收稿日期:2022-10-14
基金
湖南省医学会科研基金-临床药学项目资助(HMA202001003)
药源性器官损伤智能防控湖南省工程研究中心
湖南省药学会科研基金资助(2020YXH010)
基于真实世界数据的区域内药品临床综合评价质控体系构建研究(国家卫生健康委卫生发展研究中心)
作者信息
    中南大学湘雅三医院, 长沙 410013

通讯作者:

*左笑丛,女,主任药师 研究方向:个体化用药,肾脏药理,药品临床综合评价 Tel:(0731)88618455
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2种不同金属材料的力学参数

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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