Table 2.
Examples of CER studies that utilized observational, database methodologies.
| Author | Topic | Database - Study size (N) |
Outcomes measured | Authors conclusions |
|---|---|---|---|---|
| Dewitt et al. (31) | Nonbiologic vs. biologic DMARDs for RA treatment |
US-based observational registry (2001–2008) N=1,729 |
Clinical Disease Activity Index (CDAI) scores |
Both treatment groups experienced lower CDAI scores across time. Patients switching to bDMARD demonstrated greater improvement than patients switching to nonbiologic DMARD. |
| Grijalva et al. (32) | Patters of medication use in RA |
Tennessee Medicaid (1995–2004) N=23,342 |
Patterns of DMARD use | The utilization of DMARDs increased in TennCare patients with RA, and by 2004, use of biologics was substantial. Although glucocorticoid utilization decreased, use of both NSAIDs and narcotics increased. |
| Solomon et al. (33) | Comparative safety of opioids |
Medicare (1996–2005) N=6,275 |
Cardiovascular events, factures, gastrointestinal events |
The rates of safety events among older adults using opioids for nonmalignant pain vary significantly by agent. |
| McCutcheon et al. (34) | Surgeons vs. interventionalists in performing EVAR |
Nationwide Inpatient Sample (1998–2009) N=28,094 |
Mortality rate, length of stay, hospital charge |
Surgeons are associated with improved outcomes, with lower mortality, shorter length of stay, and lower charges for EVAR cases, when compared with interventionalists. |
| Martin et al. (35) | Three oral bisphosphonates |
Administrative claims databases (2005–2007) N=45,939 |
Fractures, time to fracture, health-care cost |
Rates of adherence and total adjusted all-cause health care costs for alendronate, risedronate, and ibandronate are similar. Absolute, unadjusted rates of fracture were small and did not significantly differ among agents. |
| Aghayev et al. (36) | Lumbar total disc arthroplasty (TDA) vs. anterior lumbar interbody fusion (ALIF) |
SWISSspine registry (2005–2010) N=534 |
QoL, pain alleviation | Pain alleviation after TDA and ALIF was similar. |
| Eurich et al. (37) | Sitagliptin vs. other glucose lower agents in type two diabetes |
US claims and integrated laboratory databases* (2004–2009) N=72,738 |
Hospital admissions, mortality |
Sitagliptin use was not associated with an excess risk of all cause hospital admission or death compared with other glucose lowering agents. |
*
Clinformatics DATA Mart, OptumInsight Life Sciences Inc.
DMARD: Disease-modifying antirhematic drugs, RA: Rheumatoid arthritis, PRO: Patient related outcome, EVAR: Endovascular aortic aneurysm repair, QoL: Quality of life