Video
What is real world evidence?
Posted by
HealthTree • July 23, 2024
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On this video

Rahul Banerjee, MD, FACP
Transcript
What is real world data? What is the difference between real world data and real world evidence? Real world data would be just looking at a map and real world evidence would be using that map to figure out the direction, where we want to go with our trip or something along those lines. Going back to the, moving away from that metaphor, I think more literally, real world data are messy. Data, plural data, data missing, so real world data are messy. Because in real life, life is messy. Patients often miss a dose because they were on vacation or in the hospital or they may have gone to urgent care for an infection and those records don't show up in the main center's data. So real world data are representative, again, the strength of them, that they represent more patients getting treatment where they are, regardless of how healthy they are, how frail they are, what language they speak, et cetera. Real world data are messier, though, because, again, of all the complexities inherent to life, real world evidence is what we do when we take those real world data and try to analyze them in a way that adjusts for some of the complexities inherent to them to kind of figure out what makes the most sense for patients. And so we'll discuss several examples of that, where we use real world data, for example, in this case, through Health Tree Cure Hub, to help identify a research question and to answer that question. And the answer to that question will be real world evidence. How is real world evidence generated from real world data? I think we should have a question in advance first. So the scientific method that all of you hearing this talk, you know, learned in middle school or high school, you may know of your children and grandchildren who've learned the same thing, is that you always start with a hypothesis. So before just seeing what happens, have a hypothesis to say, look, this is what I want to look at. And then from there, use the real world data to analyze that question. You know, those are your methods and have your results in your conclusion. And even though that sounds like something out of a high school science project, that is very literally what we still do today as clinician researchers using real world data. So in my case, for example, you know, one recent project that we'll talk about with the Health Tree Cure Hub was looking, for example, at this idea of dexamethasone, which many patients with myeloma are very familiar with being a dex or dexamethasone, you know, months, years, and what are the outcomes of it? And there are data around that that were available in Cure Hub. And so we asked a question and we said, well, is there any link between dexamethasone exposure and eye issues, for example, cataracts? And so we use the real world data to actually investigate that. And we actually did find the link that's a more, you know, milligrams, more doses of dexamethasone had received in their lifetime, milligrams per week, weeks per month, months per year, and so forth, the higher the risk of cataracts. And so we use that to generate real world evidence as our conclusion, saying that in the real world setting, dexamethasone and myeloma is associated with a higher risk of visually significant cataracts. And therefore, future studies should look at, can we get rid of the dex earlier for more patients that reduced a dose? So that would be a good example of where we took already available real world data and we mined the data. We had a specific question in mind. We went and worked with the Health Tree team in this case to answer that question. We submitted to a conference. We got it published and now it's public domain literature that hopefully will inform future studies based on that real world evidence.