Taiwan’s national research database and other stories . . .BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5395 (Published 14 October 2015) Cite this as: BMJ 2015;351:h5395
Twenty years ago Taiwan enacted a programme of universal health coverage and also set up a system for complete linkage of medical records from 1997 onwards. Now the Taiwan National Health Insurance Research Database covers 99% of the population of more than 23 million. Pharmacovigilance on a vast scale is producing new discoveries almost by the week. Recent examples include a quantification of the risk of aortic dissection in people taking fluoroquinolone antibiotics (JAMA Internal Medicine 2015, doi:10.1001/jamainternmed.2015.5389) and of optic atrophy related to amiodarone (Ophthalmology 2015, doi:10.1016/j.ophtha.2015.08.022).
A specialist diabetes clinic introduced a new handheld device that measures resting heart rate. It conducts three cardiac autonomic reflex tests to evaluate heart rate variability and is thus able to detect cardiovascular autonomic neuropathy (CAN). But a study from the clinic showed that doctors found it hard to explain what the test was about; some patients couldn’t remember …
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