Overview

1. Mission Statement

The Mission of DGI, Inc. is to improve healthcare research through the gathering and dissemination of comprehensive information on population health care data sources via an online subscription format.

Our philosophy is to present detailed information about pharmacoepidemiologic and other population data sources accessible to any individual, institution, or organization for healthcare population research. This will be accomplished by providing a standardized, up-to-date, and user-friendly online subscription resource application at www.bridgetodata.org. It is important to us to provide the most accurate and up-to-date information, and it is our hope to become a premier global resource for population research professionals requiring drug and medical data.

2. History

The need to identify all data sources for understanding drug use and its effects was initially recognized in the late 1980’s. This led to the Risk Assessment of Drugs-Analysis & Response (RAD-AR), a project initiated by Ciba-Geigy International in Basel, Switzerland. To address this need for drug risk assessment, The Degge Group, Ltd. (Degge) and Pharma Corporation (under contract with Ciba-Geigy) developed a compilation of available databases in North America, Europe, Japan and Australia -The International Drug Benefit / Risk Assessment Data Resource Handbooks. These Handbooks were later ceded to an international charity, the International Medical Benefit-Risk Foundation (IMBRF) in Geneva. In 1995, IMBRF discontinued activities, and the responsibility for the compilation of databases was turned over to Degge. Dr. Judith K. Jones, Degge’s President, elected to maintain the resource as a non-profit entity and created a Board of Advisors including a former IMBRF Board member, to maintain continuity. This led to the incorporation of a not-for-profit 501(c)(3) company called DGI, Inc. (DGI) in 1995, with the mission to continue identifying and presenting information on population healthcare databases and related resources available to the healthcare sector.

The original Handbooks were organized by geographic region and overall type of data resource and followed a standard structured summary of the type of data in the resources. There was a greater focus on population healthcare databases that included or were linkable to drug exposure; however, as the effort matured, more resources that could be used to define natural history of disease and baseline morbidity and mortality were included as well. The individual entries for 200+ databases were short, structured outlines of information that described the characteristics of a database ranging from the type and size of population, the duration of data collection, to the data elements within (e.g., diagnoses, drugs and/or procedures and coding type), that could be utilized to estimate exposure and/or risk of drugs.

In the year 2000, DGI launched an online format of these Handbooks branded as BRIDGE ON-LINESM (BRIDGE stands for Benefit Risk Information for DruG Evaluation). The web site, http://www.dgiinc.org, was an edited and updated version of the original Handbooks, accessible via subscription only, containing approximately 100 resources. In addition, the online format included databases with information on cost data for pharmacoeconomic studies.

Consistent with the company’s standard of excellence, DGI decided to update the online resource to include more in-depth information and user-friendly features, which led to the creation of B.R.I.D.G.E. TO DATASM (BRIDGE). Maintenance of BRIDGE will include continuous review of the latest publications for new and useful data sources, as well as updating of existing databases. This is a continuous process that will be maintained even after the initial re-launch of BRIDGE. Database managers will be contacted annually to assist and ensure the database profiles on BRIDGE remain current and timely.

Judith K. Jones, MD, PhD, Executive Director and Primary Editor

Dr. Judith K. Jones (MD, PhD) is an internationally recognized expert in the areas of adverse drug reactions and pharmacoepidemiology, and is Executive Director and Primary Editor of DGI, Inc. She is an internist/geriatrician and clinical pharmacologist, who was formerly Director of the Division of Drug and Biological Experience at the FDA (now Office of Safety & Epidemiology). Dr. Jones is currently a member of the clinical faculty at Georgetown University (Pharmacology) and at the University of Michigan Summer School of Public Health. Dr. Jones has served as managing editor of the database books since their inception and will continue serving as primary advisor and editor for BRIDGE.

3. Uses of B.R.I.D.G.E. TO DATASM

Epidemiology Research. One of the most important uses for BRIDGE will be as a research tool for designing an epidemiological study.

A researcher may wish to study the frequency and risk factors (disease and drug) for a rare (<1/1000) adverse event associated with a recently marketed pharmaceutical. This event is detectible as a medical diagnosis in databases that identify outpatient and hospitalization diagnoses. With the help of BRIDGE, and the guided-search tool, the researcher will be able to systematically determine which databases are available and appropriate for their study. By the end of the search, the BRIDGE user will be able to answer questions as to what databases:

  • Can identify both outpatient and inpatient diagnoses
  • Can identify both outpatient and inpatient procedures
  • Have recent data that would capture the recently approved drug
  • Include ethnicity data, if this is a risk factor
  • Have a sufficiently large population to detect this event
  • Enjoy wide use (from the literature citations) by others who are looking at rare event or other categorical questions.

Further, it will allow comparison of different databases and help the researcher decide the most appropriate database for his/her study.

Educational Tool. Another expected application of BRIDGE is as an adjunct for epidemiology education. Students in epidemiology or health economics who are new to the field may want to use the online video tutorial, the glossary, or publications listed in the database profiles to learn more about databases and the critical data elements for selected epidemiology studies. Faculty may be able to design lectures focused on specific databases types, such as medical insurance claims versus electronic medical record databases. Libraries that subscribe to BRIDGE may hold workshops or designate BRIDGE as an available resource for researchers “in training”.

Template for New Health Databases. This function of BRIDGE may be most applicable to new database managers. BRIDGE will be one of the largest compendia of population healthcare databases worldwide, with more robust search features and easy comparative capabilities between databases. Therefore, users who are interested in designing a new healthcare database may be able to search for databases in BRIDGE that have similar applications, such as drug reaction monitoring, and incorporate the data fields they feel best serve their purpose.

4. Strengths of B.R.I.D.G.E. TO DATASM

  • Based in the United States, BRIDGE provides a unique searchable and comprehensive compendium of information on population healthcare databases worldwide, allowing the health care professional to obtain profiles on various population datasets on a single website.
  • The database profiles are updated with the most current data, verified by the respective database managers or representatives. Updated database profiles replace older versions to avoid duplicate reporting.
  • BRIDGE subscribers can perform robust and advanced searches for a wide range of database profiles using our easy-to-use search page.
  • The search results are displayed based on a relevancy-ranking system that allows the profiles with the most closely-matched search terms to appear first. Highlighted fields indicate matching or non-matching data details allows for more efficient side-by-side comparison and analysis.
  • Our “Save Searches” feature can help subscribers view, update, and add to prior searches.
  • Standardized data from each database allows subscribers to compare in-depth details from multiple databases.
  • Informative resources are provided, such as a listing of recent publications using the relevant database, and contact information for database managers.
  • As part of its user-friendliness, BRIDGE also has a glossary including coding systems to guide new subscribers with their search.
  • The BRIDGE staff provides excellent customer service and can be easily contacted via phone, fax, or email to help subscribers with any questions or issues that may arise.

5. Database Profiles

The BRIDGE profiles do not include any individual patient records or proprietary data. Any decisions regarding patient records and patient confidentiality are handled through the database managers or vendors.

Fields. BRIDGE is a searchable directory allowing users to better understand the types of databases that exist, and the type of data included in them. Each of the resource profiles will include the following elements:

  • Brief database description
  • Population dynamics (e.g., size, geographical location)
  • Demographic data (e.g., ethnicity, gender, age)
  • Collection dates for data and updates
  • Diagnosis & clinical data (e.g., coding system, number of diagnoses coded)
  • Drug data (e.g., coding system, dosage)
  • Procedure data (e.g., coding practices, laboratory tests)
  • Economic data (e.g., billing, payment, cost of drugs)
  • Database linkage capabilities to other sources
  • References of published studies using data described
  • Contact and accessibility information for each database (i.e., phone, e-mail, fax)
  • Web links to respective database web sites

Types of Databases Profiled. BRIDGE contains profiles of population healthcare databases that can be classified as one or more of the following types:

  • Longitudinal Population Databases
  • Cross-sectional Population Data
  • Spontaneous Reporting System
  • National Surveillance System
  • Case Control Database
  • Registry
  • Large Clinical Trial Database
  • Tissue/Blood and Genomic/Pharmacogenetic Database
  • Other Databases