Collaborative experience

Members of the SIGMA Consortium have extensive experience in collaborating in several multi-country studies under the principles of the European Network of Centres for Pharmacoepidemiology & Pharmacovigilance (ENCePP). All members are dedicated to excellence in research by adhering to the ENCePP Guide on Methodological Standards and promoting scientific independence and transparency. Past and current examples of collaborative experience are highlighted below. All studies are registered in the EU PAS register, a publicly accessible resource for the registration of pharmacoepidemiological and pharmacovigilance studies (See Table ‘European Collaborations‘).

Each SIGMA member has access to different data, as summarized in the Table below.

The SIGMA consortium was presented virtually at ISPE’s 37th International Conference on Pharmacoepidemiology and Therapeutic Risk Management (ICPE 2021 All Access) held August 23-25 2021.

ICPE poster

Methodological Approach

The SIGMA Consortium uses state-of-the-art methodology including causal inference target trial emulation methods. 
All studies are aligned with the ENCePP research guidance, ISPE good practice guidance, and GVP module VIII principles.
In order to allow efficient execution of programs against local data, a common data model (CDM) can be used in SIGMA studies. 
SIGMA Members and Collaborators have experience in mapping to various study-specific and non-study-specific CDMs, including the ConcePTION harmonisation pipeline, BRAHMS, OMOP, Sentinel, and TheShinISS.

Members and Collaborators of the SIGMA Consortium have extensive research experience and protocol-based access to data sources for the conduct of RWE/pharmacoepidemiology studies

Name of data source
Danish Health
Registers
Finnish Health
Registers
SNDS
GePaRD
ARS Toscana
Caserta Regional
Database
THIN
PHARMO Database
Network
Norwegian Health
and Administrative
Registers
SIDIAP
Swedish Health Registers
Scottish Prescribing
Information System
CPRD
Country
Denmark
Finland
France
Germany
Italy
Italy
Italy
Netherlands
Norway
Spain
Sweden
UK
UK
Institution
Aarhus University | SDU
University of Eastern Finland
Bordeaux
PharmacoEpi
BIPS GmbH
ARS Toscana
University of
Verona
UNIMIB
PHARMO Institute
NIPH
IDIAP JGol
Karolinska
Institute
University of
Dundee
RTI Health Solutions | Ultretch Univerity
Name of database Country
Type
Danish Health Registers
Linked registers for dispensed prescriptions, laboratory values, hospitalizations, and mortality
Finnish Health Registers
Linked national registers for dispensed prescriptions, hospitalisations and outpatient visits, laboratory values, mortality, causes of death​
SNDS
Claims
GePaRD
Claims from 4 SHI proveiders
ARS Toscana
Claims data
Caserta Regional Database
Claims
THIN
Primary health care electronic medical records
PHARMO Database Network
Primary health care electronic medical record + partial linkage to other dcata
Norwegian Health and Administrative Registers
Linked national registers for dispensed prescriptions, hospitalizations, specialist outpatient care, primary care, and causes of death
SIDIAP
Primary health care electronic medical records + partial linkage to other data
Swedish Health Registers
Linked national national refisters for dispensed prescriptions, hospitalizations, and mortality.
Scottish Prescribing Information System
Prescriptions linked to diagnoses
CPRD
Primary healt care electronic medical records + partial linkage to other data
Name of database Country
Size
Danish Health Registers
5.8 million
Finnish Health Registers
5.5 million
SNDS
66 million
GePaRD
17.5 million
ARS Toscana
3.6 million
Caserta Regional Database
1.2 million
THIN
1.7 million full db
/ 860.000 active
patients
PHARMO Database Network
4 million
Norwegian Health and Administrative Registers
5.5 million
SIDIAP
5.6 million
Swedish Health Registers
10.5 million
Scottish Prescribing Information System
5.4 million
CPRD
 Aurum: 13.3 million GOLD: 2.9 million of acceptable patients
Name of database Country
(% coverage)
Danish Health Registers
(100% Denmark)
Finnish Health Registers
(100% Finland)
SNDS
(99% France)
GePaRD
(21% Germany)
ARS Toscana
(100% Tuscany region)
Caserta Regional Database
(21% Campania region)
THIN
(1,5% Italy)
PHARMO Database Network
(23% Netherlands)
Norwegian Health and Administrative Registers
(100% Norway)
SIDIAP
(73% Catalonia)
Swedish Health Registers
(100% Sweden)
Scottish Prescribing Information System
(100% Scotland)
CPRD
(Aurum: 19.83 % UK, GOLD: 4.4% UK)
Name of database Country
Prescription/dispensings data
Danish Health Registers
Finnish Health Registers
SNDS
GePaRD
ARS Toscana
Caserta Regional Database
THIN

(prescription data)
PHARMO Database Network
Norwegian Health and Administrative Registers
SIDIAP
Swedish Health Registers
Scottish Prescribing Information System
CPRD
Name of database Country
Hospital data
Danish Health Registers
Finnish Health Registers
SNDS
GePaRD
ARS Toscana
Caserta Regional Database
THIN

(partial)
PHARMO Database Network
Norwegian Health and Administrative Registers
SIDIAP
Swedish Health Registers
Scottish Prescribing Information System
CPRD
Name of database Country
Primary care data
Danish Health Registers
Finnish Health Registers

(since 2011)
SNDS
GePaRD
ARS Toscana
Caserta Regional Database
THIN
PHARMO Database Network
Norwegian Health and Administrative Registers
SIDIAP
Swedish Health Registers
Scottish Prescribing Information System
CPRD
Name of database Country
Laboratory data
Danish Health Registers
Finnish Health Registers

(since 2014)
SNDS
GePaRD
ARS Toscana
Caserta Regional Database

(Lab test request available;
around 20% of the of the lab tests
results for
people residing in Caserta
are performed in
public healthcare structures
and can be traced)
THIN

(partial)
PHARMO Database Network
Norwegian Health and Administrative Registers

(Only positive tests fot notifiable infectious diseases)
SIDIAP
Swedish Health Registers
Scottish Prescribing Information System
CPRD
Name of database Country
Cancer data
Danish Health Registers
Finnish Health Registers
SNDS
GePaRD
ARS Toscana
Caserta Regional Database
THIN

(partial)
PHARMO Database Network
Norwegian Health and Administrative Registers
SIDIAP
Swedish Health Registers
Scottish Prescribing Information System
CPRD
Name of database Country
Pregnancy data
Danish Health Registers
Finnish Health Registers
SNDS
GePaRD
ARS Toscana
Caserta Regional Database

(pregnant persons can be identified through birth registry - 2018)
THIN

(partial)
PHARMO Database Network
Norwegian Health and Administrative Registers
SIDIAP
Swedish Health Registers
Scottish Prescribing Information System
CPRD
Name of database Country
Emergency data
Danish Health Registers
Finnish Health Registers

(limited)
SNDS
GePaRD
ARS Toscana
Caserta Regional Database

(limited)
THIN
PHARMO Database Network
Norwegian Health and Administrative Registers
SIDIAP
Swedish Health Registers
Scottish Prescribing Information System
CPRD
Most relevant publication
Most relevant publication
Danish Health Registers
Danish HC system publication
Finnish Health Registers
Finnish HC registers publication
SNDS
French HC system publication-1
French HC system publication-2
GePaRD
GePaRD publication
ARS Toscana
Italy HC DBs publication-1
Italy HC DBs publication-2
Caserta Regional Database
Caserta study publication
THIN
PHARMO Database Network
PHARMO DB Network publication
Norwegian Health and Administrative Registers
Nordic Health Registry-Based Research publication
SIDIAP
Swedish Health Registers
Nordic Health Registry-Based Research publication
Scottish Prescribing Information System
PIS publication
CPRD
CPRD Aurum publication
ARS = Agenzia regionale di sanità; CPRD = Clinical Practice Research Datalink;  GePaRD = German Pharmacoepidemiological Research Database; NIPH = Norwegian Institute of Public Health; SDU = Southern Denmark University; SIDIAP = Sistema d'Informació per al Desenvolupament de la Investigació en Atenció Primaria; SNDS = French National Healthcare System database; THIN = The Health Improvement Network; UNIMIB = University of Milano Bicocca.

European collaborations

Full Title & EUPAS Link Funding entity Coord. Center Other Participating SIGMA Members Start Year
Background rates of Adverse Events of Special Interest for monitoring COVID-19 vaccines European Medicines Agency (EMA) UMCU, Aarhus U., ARS Toscana, BIPS, BPE, IDIAPJGol, PHARMO, RTI-HS, Utrecht U. 2020
Drug-drug interactions between dicloxacillin/flucloxacillin and DOACs N/A SDU, Utrecht U. 2020
Strengthening Use of Real-World Data in Medicines Development: Metadata for Data Discoverability and Study Replicability European Medicines Agency (EMA) RTI-HS, Aarhus U., ARS Toscana, BIPS, BPE, PHARMO, UMCU, Utrecht U. 2020
CONSIGN study: COVID-19 infection and medicines in pregnancy - a multinational registry based study European Medicines Agency (EMA) Aarhus U., ARS Toscana, BIPS, BPE, RTI-HS, UMCU, Utrecht U. 2020
Data source heterogeneity in multi-database pharmacoepidemiologic studies: a scoping review (DIVERSE) International Society for Pharmacoepidemiology (ISPE) Utrecht U., ARS Toscana 2020
Description of international collaboration in the area of medicines use and effects in COVID-19 affected pregnancies (CONSIGN-International)) European Medicines Agency (EMA) UMCU, Aarhus U., ARS Toscana, BIPS, BPE, RTI-HS, Utrecht U. 2020
Cohort monitoring of Adverse Events of Special Interest and COVID-19 diagnoses prior to and after COVID-19 vaccination European Medicines Agency (EMA) UMCU, ARS Toscana, PHARMO, Utrecht U. 2020

Epidemiological assessment of the risk for pancreatic cancer associated with the use of semaglutide in patients with type 2 diabetes- A cohort study based on Nordic registry data 		Novo Nordisk A/S SDU, NIPH 2018

Post Conditional Approval Active Surveillance Study Among Individuals in Europe Receiving the Pfizer-BioNTech Coronavirus Disease 2019 (COVID-19) Vaccine 		Pfizer RTI-HS, UMCU, ARS Toscana, IDIAPJGol, PHARMO 2020
Pregnancy outcomes in women exposed to oral cladribine: a multi-country cohort database study Merck Healthcare KGaA RTI-HS, Dundee U. 2019
A Retrospective Cohort Study to Assess Drug Utilisation and Long-Term Safety of Galcanezumab in European Patients in the Course of Routine Clinical Care Eli Lilly and Company PHARMO, ARS Toscana, BIPS, BPE, IDIAPJGol 2019
Adherence, persistence and switching patterns – once- and twice-daily direct oral anticoagulants Daiichi Sankyo Europe GmbH PHARMO, ARS Toscana, BIPS 2019