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  1. Article ; Online: Application of the U.S. Food and Drug Administration's Sentinel Routine Querying Tools to the Taiwan Sentinel Data Model-formatted National Health Insurance Research Database.

    Lin, Fang-Ju / Huang, Ling-Ya / Wang, Chi-Chuan / Toh, Sengwee

    Journal of food and drug analysis

    2024  Volume 31, Issue 4, Page(s) 772–781

    Abstract: The U.S. Food and Drug Administration's Sentinel System is a leading distributed data network for drug safety surveillance in the world. The National Health Insurance Research Database (NHIRD) in Taiwan was converted into the Taiwan Sentinel Data Model ( ... ...

    Abstract The U.S. Food and Drug Administration's Sentinel System is a leading distributed data network for drug safety surveillance in the world. The National Health Insurance Research Database (NHIRD) in Taiwan was converted into the Taiwan Sentinel Data Model (TSDM) based on the Sentinel Common Data Model (SCDM) version 6.0.2. The goal of this study was to investigate the feasibility of applying the same study designs, analytic choices, and analytic tools as used by the U.S. Sentinel System to examine the same drug-outcome associations in the TSDM-formatted NHIRD. Four known drug-outcome associations previously examined by the U.S. Sentinel System were selected as the use cases: (1) use of angiotensin-converting enzyme inhibitors (ACEIs) and risk of angioedema, (2) use of warfarin and risk of gastrointestinal bleeding, (3) use of oral clindamycin and risk of Clostridioides difficile infection (CDI), and (4) use of glyburide and risk of serious hypoglycemia. We followed the same study designs and analytic choices used by the U.S. Sentinel System and applied the Sentinel Routine Querying Tools to answer the same study questions within the TSDM-formatted NHIRD. The results showed that ACEIs were associated with a non-significant increase in risk of angioedema compared to beta-blockers (hazard ratio [HR]: 1.21; 95% confidence interval [CI]: 0.89-1.64); warfarin was associated with a higher risk of gastrointestinal bleeding compared to statins (HR: 1.72; 1.50-1.98); glyburide was associated with an increased risk of hypoglycemia compared to glipizide (HR: 1.61, 1.30-2.00). We were unable to evaluate the association between oral clindamycin and risk of CDI due to the low event number. Our study demonstrated that it was feasible to directly apply the publicly available Sentinel Routine Querying Tools within the TSDM-formatted NHIRD. However, sources of heterogeneity other than design and analytic differences should be carefully considered when comparing the results between the two systems.
    MeSH term(s) United States ; Humans ; Pharmaceutical Preparations ; Warfarin ; Clindamycin ; Glyburide ; United States Food and Drug Administration ; Taiwan ; Angiotensin-Converting Enzyme Inhibitors ; Gastrointestinal Hemorrhage/chemically induced ; Hypoglycemia/chemically induced ; Angioedema/chemically induced ; Angioedema/epidemiology
    Chemical Substances Pharmaceutical Preparations ; Warfarin (5Q7ZVV76EI) ; Clindamycin (3U02EL437C) ; Glyburide (SX6K58TVWC) ; Angiotensin-Converting Enzyme Inhibitors
    Language English
    Publishing date 2024-03-25
    Publishing country China (Republic : 1949- )
    Document type Journal Article
    ISSN 2224-6614
    ISSN (online) 2224-6614
    DOI 10.38212/2224-6614.3482
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Comparison of different direct oral anticoagulant regimens in atrial fibrillation patients with high bleeding risk.

    Ciou, Wei-Siang / Wang, Chi-Chuan / Lin, Fang-Ju / Chao, Tze-Fan / Lin, Shin-Yi

    Heart rhythm

    2024  

    Abstract: Background: The optimal dose of direct oral anticoagulants (DOACs) to prevent ischemic stroke (IS) and systemic thromboembolism (STE) in atrial fibrillation (AF) patients with a predisposing bleeding risk remains unclear.: Objective: The purpose of ... ...

    Abstract Background: The optimal dose of direct oral anticoagulants (DOACs) to prevent ischemic stroke (IS) and systemic thromboembolism (STE) in atrial fibrillation (AF) patients with a predisposing bleeding risk remains unclear.
    Objective: The purpose of this study was to compare the effectiveness and safety of different DOAC dosage regimens in AF patients with high bleeding risk but low thrombosis risk.
    Methods: This retrospective observational study was conducted with the National Health Insurance claims database in Taiwan to include AF patients aged 20 up to 75 years, under DOAC therapy, with CHA
    Results: A total of 964 patients were included (52.1% standard-dose regimen). Median HAS-BLED score was 3 [interquartile range 3-3]. Compared with standard-dose group, patients in the low-dose group had a significantly increased risk of IS (adjusted hazard ratio [aHR] 5.13; 95% confidence interval 1.37-19.22) and STE (aHR 3.14 [1.05-9.37]) but similar risk of MB (aHR 0.45 [0.12-1.67]). The risks of other hemorrhage and cardiovascular death were similar between the 2 dose groups.
    Conclusion: Among patients with a predominant bleeding risk but relatively low thrombosis risk, the low-dose DOAC regimen is not a more appropriate selection than standard-dose regimen.
    Language English
    Publishing date 2024-01-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2024.01.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Comparison of Clinical Outcomes Among Different Fixed-Dose Combinations of Long-Acting Muscarinic Antagonists and Long-Acting β

    Weng, Ching-Fu / Wu, Chien-Chih / Wu, Mei-Hsuan / Lin, Fang-Ju

    Chest

    2022  Volume 163, Issue 4, Page(s) 799–814

    Abstract: Background: Researchers have yet to obtain conclusive evidence differentiating among fixed-dose combinations (FDCs) of long-acting muscarinic antagonists (LAMAs) and long-acting β: Research question: What are the differences between available LAMA/ ... ...

    Abstract Background: Researchers have yet to obtain conclusive evidence differentiating among fixed-dose combinations (FDCs) of long-acting muscarinic antagonists (LAMAs) and long-acting β
    Research question: What are the differences between available LAMA/LABA FDCs in the risk of acute exacerbation (AE) and cardiovascular events?
    Study design and methods: This retrospective cohort study based on a national insurance claims database included patients with COPD ≥ 40 years of age who were newly prescribed glycopyrronium (GLY)/indacaterol (IND), umeclidinium (UMEC)/vilanterol (VI), or tiotropium (TIO)/olodaterol (OLO) FDC between January 1, 2015, and June 30, 2019. Propensity score matching and Cox regression models were used to compare outcomes of AE and cardiovascular events associated with LAMA/LABA FDC treatment.
    Results: Among the 44,498 patients identified and included, 15,586 received GLY/IND, 20,460 received UMEC/VI, and 8,452 received TIO/OLO. Baseline characteristics were well balanced after 1:1 matching of UMEC/VI and GLY/IND, 2:1 matching of UMEC/VI and TIO/OLO, and 2:1 matching of GLY/IND and TIO/OLO. Risk of severe AE was lower among patients treated with UMEC/VI or GLY/IND than among those who received TIO/OLO (UMEC/VI vs TIO/OLO: 17.85 vs 29.32 per 100 person-years; hazard ratio, 0.76; 95% CI, 0.68-0.84; GLY/IND vs TIO/OLO: 15.54 vs 25.53 per 100 person-years; hazard ratio, 0.77; 95% CI, 0.67-0.88). In addition, GLY/IND users tended to have a lower risk of cardiovascular events than TIO/OLO users, but the difference dissipated when restricting follow up to a shorter duration.
    Interpretation: Our results revealed that the risk of severe AE was lower among patients with COPD receiving UMEC/VI or GLY/IND than among those receiving TIO/OLO, whereas the incidence of cardiovascular events was similar across groups but was slightly lower in GLY/IND users when compared with TIO/OLO users. Further research will be required to confirm these findings.
    MeSH term(s) Humans ; Muscarinic Antagonists/therapeutic use ; Retrospective Studies ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/chemically induced ; Benzyl Alcohols/therapeutic use ; Chlorobenzenes/therapeutic use ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/drug therapy
    Chemical Substances Muscarinic Antagonists ; Benzyl Alcohols ; Chlorobenzenes
    Language English
    Publishing date 2022-11-26
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2022.11.027
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Prescribing patterns for attention deficit hyperactivity disorder among children and adolescents in Taiwan from 2004 to 2017.

    Liao, Heng-Ching / Lin, Fang-Ju / Hsu, Chien-Ning / Gau, Susan Shur-Fen / Wang, Chi-Chuan

    Journal of the Formosan Medical Association = Taiwan yi zhi

    2023  Volume 122, Issue 6, Page(s) 514–517

    Abstract: This study documented the prescribing patterns of methylphenidate and atomoxetine among patients aged 3 to 18 in Taiwan diagnosed with attention deficit hyperactivity disorder (ADHD) between 2004 and 2017. Initial treatment for ADHD, the time between the ...

    Abstract This study documented the prescribing patterns of methylphenidate and atomoxetine among patients aged 3 to 18 in Taiwan diagnosed with attention deficit hyperactivity disorder (ADHD) between 2004 and 2017. Initial treatment for ADHD, the time between the first diagnosis and the first prescription, and medication-switching patterns were investigated. The final cohort consisted of 256,882 patients, and 147,210 (57.3%) of them received medication treatment. Most of the patients (98.2%) received methylphenidate. Atomoxetine use increased from 0.1% in 2007 to 5.5% in 2017. The median time between the ADHD diagnosis and the first prescription was 21 days (IQR: 0-212 days). In patients who initiated methylphenidate, 12,406 (8.4%) patients switched to atomoxetine; 850 (31.3%) of the children began with atomoxetine and switched to methylphenidate. In conclusion, methylphenidate was the predominant treatment for ADHD in 2004-2017. However, the prevalence of pharmacotherapy for ADHD was relatively low. Further investigation on the reasons behind this pattern is recommended.
    MeSH term(s) Humans ; Child ; Adolescent ; Attention Deficit Disorder with Hyperactivity/drug therapy ; Atomoxetine Hydrochloride/therapeutic use ; Central Nervous System Stimulants/therapeutic use ; Taiwan ; Methylphenidate/therapeutic use ; Adrenergic Uptake Inhibitors/therapeutic use ; Adrenergic Uptake Inhibitors/adverse effects
    Chemical Substances Atomoxetine Hydrochloride (57WVB6I2W0) ; Central Nervous System Stimulants ; Methylphenidate (207ZZ9QZ49) ; Adrenergic Uptake Inhibitors
    Language English
    Publishing date 2023-03-15
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 2096659-3
    ISSN 1876-0821 ; 0929-6646
    ISSN (online) 1876-0821
    ISSN 0929-6646
    DOI 10.1016/j.jfma.2023.02.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Real-world epidemiology, treatment patterns and disease burden of patients diagnosed with chronic hepatitis B in Taiwan.

    Chien, Hsiu-Ting / Su, Tung-Hung / Huang, Hazel / Chiang, Chih-Lin / Lin, Fang-Ju

    Liver international : official journal of the International Association for the Study of the Liver

    2023  Volume 43, Issue 11, Page(s) 2404–2414

    Abstract: Background and aims: This study aimed to update the epidemiology, clinical, and economic outcomes of patients diagnosed with chronic hepatitis B (CHB) infection in Taiwan.: Methods: This is a retrospective observational study using claims data from ... ...

    Abstract Background and aims: This study aimed to update the epidemiology, clinical, and economic outcomes of patients diagnosed with chronic hepatitis B (CHB) infection in Taiwan.
    Methods: This is a retrospective observational study using claims data from the National Health Insurance Research Database. Cases were identified between 2010 and 2019 using CHB diagnosis codes and claims for alanine aminotransferase laboratory tests or CHB treatment within one year of the first CHB diagnosis. Patient characteristics, epidemiology, clinical, and economic outcomes were described.
    Results: A total of 730 154 CHB-diagnosed cases were identified. The prevalence of diagnosed CHB increased from 1.13% in 2010 to 2.43% in 2019, with the highest occurring among those aged 55-64 years (4.76%) and 45-54 years (4.37%) and being higher in men (2.98%) than in women (2.21%). The majority of newly diagnosed CHB patients were 35 years of age or older (86.6%), with a median age of 49 years. After a median follow-up period of 6.42 years, 12.5%, 7.9%, 2.8%, and 0.35% were diagnosed with cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and liver transplantation respectively. Among 456 706 incident CHB-diagnosed patients, 17.4% had received at least one CHB medication, with the majority taking entecavir (67.9%). Patients with increasing disease severity had higher healthcare resource utilization, and inpatient costs accounted for 48.9%-65.5% of the overall medical cost in different health states.
    Conclusion: Despite the decreasing incidence of newly diagnosed CHB, the prevalence of diagnosed CHB remains high and poses a significant healthcare challenge owing to the high economic burden associated with the complications of CHB.
    MeSH term(s) Male ; Humans ; Female ; Middle Aged ; Adult ; Hepatitis B, Chronic/complications ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/drug therapy ; Taiwan/epidemiology ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/therapy ; Cost of Illness ; Liver Neoplasms/pathology ; Antiviral Agents/therapeutic use
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2023-08-24
    Publishing country United States
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.15702
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Response.

    Lin, Fang-Ju / Chang, Ting-Yu / Chien, Jung-Yien

    Chest

    2020  Volume 157, Issue 6, Page(s) 1684

    MeSH term(s) Adrenal Cortex Hormones ; Humans ; Pulmonary Disease, Chronic Obstructive
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2020-06-05
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2020.02.055
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Absence of renal cortical anisotropic backscattering artifact in feline chronic kidney disease.

    Chou, Ping-Hsien / Heng, Hock Gan / Lin, Fang-Ju / Chen, Kuan-Sheng

    The veterinary quarterly

    2021  Volume 41, Issue 1, Page(s) 210–216

    Abstract: Renal cortical anisotropy backscattering artifact (CABA) is a focal hyperechoic region where the tubules are parallel to the incident ultrasound beam, reflecting most of the beams to the transducer. To investigate the association between chronic kidney ... ...

    Abstract Renal cortical anisotropy backscattering artifact (CABA) is a focal hyperechoic region where the tubules are parallel to the incident ultrasound beam, reflecting most of the beams to the transducer. To investigate the association between chronic kidney disease (CKD) and the absence of renal CABA in cats. Ultrasonographic renal images of 40 cats with CKD (stage II-IV) and 36 clinically healthy cats were blindly evaluated by two observers to determine the visibility of renal CABA. Inter- and intraobserver agreements were evaluated using McNemar's test. The association between the absence of renal CABA and CKD was assessed using Fisher's exact test. Excellent intraobserver and substantial interobserver agreements were demonstrated. A significant association (
    Language English
    Publishing date 2021-06-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 754161-2
    ISSN 1875-5941 ; 0165-2176
    ISSN (online) 1875-5941
    ISSN 0165-2176
    DOI 10.1080/01652176.2021.1941397
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Adherence to Statins Use and Risk of Dementia among Patients with Diabetes and Comorbid Hyperlipidemia.

    Chang, Ching-Yuan / Lin, Fang-Ju / Hong, Jin-Liern / Wu, Chung-Hsuen

    Inquiry : a journal of medical care organization, provision and financing

    2021  Volume 58, Page(s) 469580211019201

    Abstract: The results from previous observational studies and clinical trials about the neuroprotective benefits of statins use for the prevention of dementia are contradictory. It is unclear whether the neuroprotective benefits are experienced in a specific group ...

    Abstract The results from previous observational studies and clinical trials about the neuroprotective benefits of statins use for the prevention of dementia are contradictory. It is unclear whether the neuroprotective benefits are experienced in a specific group with a higher risk of dementia, such as patients with concurrent diabetes and hyperlipidemia. We aimed to examine the association between adherence to statins and the risk of dementia among patients with diabetes and comorbid hyperlipidemia. This was a retrospective study with a new user design. We used data from the Taiwan National Health Insurance Research Database to identify patients with diabetes and comorbid hyperlipidemia. The occurrence of dementia was the study outcome. The adherence to statins was the exposure, which was measured by the proportion of days covered (PDC) of statins. The good adherence included patients with ≥80% PDC of statins. Cox proportional hazards regression models were used to evaluate the association between adherence to statins and dementia. Among 18,125 included individuals with diabetes and comorbid hyperlipidemia, 33.5% had good adherence to statins. Compared to poor adherence to statins, good adherence to statins was not significantly associated with a reduced risk of dementia (hazard ratio = 0.94; 95%confidence interval = 0.70-1.24) among patients with diabetes and comorbid hyperlipidemia. Good adherence to statins was not found to be associated with the risk of dementia among patients with diabetes and comorbid hyperlipidemia in Taiwan. Future studies with a more diverse study population are needed to evaluate the neuroprotective effects of statins use on dementia prevention.
    MeSH term(s) Dementia/epidemiology ; Diabetes Mellitus/epidemiology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias/drug therapy ; Hyperlipidemias/epidemiology ; Retrospective Studies
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2021-05-26
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 42153-4
    ISSN 1945-7243 ; 0046-9580
    ISSN (online) 1945-7243
    ISSN 0046-9580
    DOI 10.1177/00469580211019201
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Correction: Increased non-typhoidal Salmonella hospitalizations in transfusion-naïve thalassemia children: a nationwide population-based cohort study.

    Sheen, Jiunn-Ming / Lin, Fang-Ju / Yang, Yao-Hsu / Kuo, Kuang-Che

    Pediatric research

    2021  Volume 91, Issue 7, Page(s) 1917

    Language English
    Publishing date 2021-09-03
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-021-01662-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Increased non-typhoidal Salmonella hospitalizations in transfusion-naïve thalassemia children: a nationwide population-based cohort study.

    Sheen, Jiunn-Ming / Lin, Fang-Ju / Yang, Yao-Hsu / Kuo, Kuang-Che

    Pediatric research

    2021  Volume 91, Issue 7, Page(s) 1858–1863

    Abstract: Introduction: Although non-typhoidal Salmonella (NTS) infection usually causes self-limited enterocolitis, several risk factors have been found to predispose individuals to more severe NTS infections. However, few studies have discussed the association ... ...

    Abstract Introduction: Although non-typhoidal Salmonella (NTS) infection usually causes self-limited enterocolitis, several risk factors have been found to predispose individuals to more severe NTS infections. However, few studies have discussed the association between NTS infection and pediatric thalassemia populations.
    Material and methods: A nationwide population-based retrospective cohort study was conducted using medical records of the selected children from the Taiwan National Health Insurance Research Database. Immunocompromised individuals or patients with a history of transfusion or splenectomy were excluded. One thalassemia patient was matched with four non-thalassemia patients based on their year of birth, sex, and urbanization level.
    Results: In this cohort, 912 patients with thalassemia and 3648 comparison cohort were analyzed. The mean age of NTS hospitalization was 2.0 ± 1.4 in thalassemia cohort and 2.6 ± 2.4 in non-thalassemia cohort. Transfusion-naïve thalassemia children were proved to have a higher rate of NTS hospitalization (6.90 vs 4.11 per 1000 person-year; p = 0.0004) than the non-thalassemia cohort, with an adjusted hazard ratio (HR) of 1.68 (95% confidence interval [CI] = 1.26-2.24).
    Conclusion: Our research shows that transfusion-naïve thalassemia is associated with an increased risk of NTS hospitalization. Further prospective study comparing the incidence and severity of NTS infection among children with and without thalassemia is needed.
    Impact: Pediatric transfusion-naïve thalassemia patients have an 1.68-fold increased risk for hospitalization due to non-typhoidal Salmonella (NTS) infection. This is the first nationwide population-based cohort study based on an extremely large database that shows pediatric transfusion-naïve thalassemia patients have an increased risk for NTS hospitalizations. Besides the previously known risk factors such as extremes of age, sickle cell disease, or immunosuppressing conditions, clinicians must also take thalassemia as a possible risk factor for more severe NTS disease.
    MeSH term(s) Child ; Cohort Studies ; Hospitalization ; Humans ; Prospective Studies ; Retrospective Studies ; Salmonella ; Salmonella Infections/complications ; Salmonella Infections/epidemiology ; Thalassemia/complications ; Thalassemia/epidemiology ; Thalassemia/therapy
    Language English
    Publishing date 2021-06-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-021-01602-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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