Evidence map›Paper›PMID 42489799›Full record

ArticleDrugs - real world outcomes2026

Feasibility of Reconstructing Survival Outcomes from Unstructured Electronic Medical Records under Japan's Next-Generation Medical Infrastructure Act: A Historical Cohort Study of Atezolizumab in Non-small Cell Lung Cancer.

Masahiko Nakatsui, Yosuke Nishida, Suguru Nozue, Yukinori Sakata, Mie Azuma, Rika Abe, Rika Okamoto, Yuki Nakagami, Yasushi Okuno

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Article in Drugs - real world outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Masahiko NakatsuiGraduate School of Medicine, Yamaguchi University, Ube, Japan. nakatsui@yamaguchi-u.ac.jp.ORCID http://orcid.org/0000-0001-6531-5220
Yosuke NishidaPharmaceutical & Chemical Division Industry Business Sector, NTT DATA Corporation, Tokyo, Japan.
Suguru NozueBusiness Engineering Services Division System Integration Sector, NTT DATA Corporation, Tokyo, Japan.
Yukinori SakataEisai Co., Ltd, Tokyo, Japan.
Mie AzumaEisai Co., Ltd, Tokyo, Japan.
Rika AbeRIKEN Center for Computational Science, Kobe, Japan.
Rika OkamotoTranslational Research Centre for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan.
Yuki NakagamiFaculty of Data Science, Shimonoseki City University, Shimonoseki, Japan.
Yasushi OkunoRIKEN Center for Computational Science, Kobe, Japan.

Funding

JSPS KAKENHI JP23K11933
6 · The paper itself

Abstract

BACKGROUND AND

objectiveAs the use of real-world evidence (RWE) expands, evaluating whether Japanese real-world data (RWD) can reproduce clinical trial findings is crucial. This study aimed to determine whether pseudonymized medical information collected under the Next-Generation Medical Infrastructure Act could reconstruct a patient cohort comparable to the Japanese subgroup of the OAK trial and to evaluate progression-free survival (PFS) and overall survival (OS) in patients with non-small cell lung cancer (NSCLC) treated with atezolizumab.

methodsWe conducted a historical cohort study using the Millennium Medical Record database. Medical information collected between 1 October 2015, and 31 October 2022 was utilized, and the study itself was conducted from September 2023 to February 2024. Patients treated with atezolizumab for NSCLC were identified, and eligibility criteria from the OAK trial were applied. Effectiveness outcomes were extracted from unstructured electronic medical record text by trained abstractors through manual review of the medical records, ensuring robustness of the assessments.

resultsA total of 75 patients were analyzed. The median PFS was 3.5 months (95% CI 2.3-8.9), comparable to the 4.2 months (95% CI 2.8-4.4) reported in the OAK trial's Japanese subgroup. Subgroup analyses showed numerical distance, with shorter PFS in patients with advanced stage and poor performance status, consistent with clinical expectations. Median OS was not reached, likely due to censoring from untracked hospital transfers.

conclusionsThis study demonstrated the feasibility of extracting PFS from unstructured text in RWD, yielding results comparable to clinical trials. While OS estimation faced challenges due to tracking limitations, future integration with the National Database under the revised law is expected to enhance accuracy, paving the way for using this infrastructure to generate external control arms.

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.