Real world data (RWD) is defined by FDA as “the data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources” while real world evidence (RWE) is “the clinical evidence regarding the usage and potential benefits or risks of a medical product derived from analysis of RWD” [1].
More broadly, RWD and RWE can be defined as health-related data / evidence obtained from multiple sources outside of traditional clinical research trials, and accordingly, RWE is typically valued based on its’ potential in complementing and validating clinical trial data [2].
Figure 1 highlights some selected examples and future visions on how RWD and RWE can be utilized, adopting a wider perspective on the possibilities. For example, utilization of RWE includes assessments of treatment needs, treatment paths and impact of an intervention on health status and quality of life. Growing data sources provide new opportunities in developing diagnostics for rare diseases and planning clinical trials. From a health economic point of view, RWE can be utilized to provide local resource and cost information and for comparison of costs and health effects between different treatments.
It seems likely that we have only begun to understand the full potential of RWE in decision-making and that many decisions will apply RWE in the future.
In Finland, we have unique opportunities in utilizing real world data. Our existing national registries, dating back several decades, constitute the main data sources for nation-wide evaluations, while region-specific registry data in data lakes provide means to assess disease features in-depth as presented in Figure 2. Further, national and regional biobanks provide valuable sources of clinical data for RWE studies. Figure 2 illustrates the types of clinical data accessible from electronic patients records for such studies. Importantly, information between the various data sources can be interconnected through the national ID number, as illustrated further in figure 3.
To support the use of health and wellbeing data, Finland has renewed the legislation and, launched a national permission authority and service operator Findata. This “one-stop shop” serves a more straightforward and easier access to data from multiple sources. Other ongoing actions have included the establishment of the Finnish Biobank Cooperative, FINBB, supporting the development of biobanks, the development of hospital data lakes and disease-specific registries, as well as efforts regarding the collection and use of genome data. Besides research, new possibilities of using RWE include decision-making, product development and innovations. These efforts have advanced the role of RWE in Finland and have attracted considerable attention also globally.
Multiple myeloma significantly increases the risk of infections. A recent real-world evidence (RWE) study revealed that multiple myeloma (MM) patients experience more infections compared to healthy controls, even prior to diagnosis. Infections, both before and after diagnosis, were associated with an increased mortality.
Despite its high-risk nature and availability of kidney treatments, chronic kidney disease (CKD) often goes undiagnosed. This especially concerns patients without type 2 diabetes (T2D), who represent the majority of CKD patients. This finding comes from a recent registry study published in Nephrology Dialysis Transplantation (NDT).
The adoption of new diabetes medications in Finland was active between 2012 and 2019, according to an RWE (Real World Evidence) study published in May 2024. The study was conducted by Medaffcon in collaboration with the pharmaceutical company Sanofi.