Real-World Database Studies in Oncology: A Call for Standards
Menée aux Etats-Unis à partir de données 2014-2015 portant sur 101 649 patients atteints d'un cancer de stade avancé (stade III/IV ; âge : 20-69 ans), cette étude analyse la prévalence de difficultés financières importantes (faillites, expulsions, etc.) avant le diagnostic de la maladie puis évalue l'association entre ces difficultés et le stade de la maladie au diagnostic
Real-world data (RWD), the data relating to patient health status and routinely collected in the delivery of health care, can provide critical evidence about care and outcomes across the cancer continuum. When analyzed using rigorous methods, RWD can address a number of important questions that are not practical, feasible, or ethical to address with clinical trials. This important advantage of RWD is also a limitation, namely, what is captured in real-world databases reflects the observed experiences, preferences, and biases of patients, providers, and health care itself, with only a partial accounting for factors that may influence those outcomes. As such, real world evidence (RWE)—the clinical evidence emerging from the usage and analysis of RWD1—is subject to important biases and limitations that must be appropriately acknowledged and addressed conceptually and methodologically before clinical or policy inferences can be made regarding the findings.