Real-world evidence
Sweden's national registers offer an unmatched setting to study treatment effectiveness, safety, and health outcomes at population scale. We combine deep biostatistics and epidemiology with detailed knowledge of the Nordic registers to deliver real-world evidence that holds up to scrutiny.
From study design through to publication, built on the methods we develop and the software we ship — see them in action in the case studies.
Population-scale data, linkable and deep
Sweden maintains comprehensive national medical and sociodemographic registers spanning decades — around 150 disease-specific quality registers, all linkable through the national personal-identity number. Quality registers are reviewed annually and certified at levels 1–3, with Level 1 requiring 85%+ coverage.
Oncology & haematology
Quality registers spanning prostate, breast, lung, and colorectal cancers, and lymphoma.
Cardiovascular disease
Acute myocardial infarction, vascular surgery, and stroke registers.
Other disease areas
Diabetes, kidney disease, rheumatology, inflammatory bowel disease, and assisted reproductive techniques.
End-to-end, from question to publication
End-to-end support for Swedish register studies — from the initial research question and ethics applications through to peer-reviewed publication, across haematology, oncology, hepatology, cardiology, rheumatology, and nephrology.
Scope & feasibility
We start from your research question and tell you honestly what the registers can — and can't — answer, and how the study would be framed.
Design & analysis plan
Study design, protocol, and a pre-specified statistical analysis plan, matched to the question and the register data and follow-up available.
Ethics & data access
Ethics applications and approvals, and the register data requests — we know the Swedish process and the register holders, so access is handled correctly from the start.
Linkage & data management
Linking medical and sociodemographic registers through the national personal-identity number, then cleaning and building a documented, analysis-ready dataset.
Statistical analysis
Survival, competing-risks, multi-state, and joint models, with causal-inference designs and regression standardisation — censoring and confounding handled correctly, not naïvely. Our primary route to a comparative estimate is g-formula standardisation, with propensity-score or matching-adjusted weighting applied at the standardisation step rather than as the estimator itself, and analytic M-estimation standard errors instead of the bootstrap. It is a deliberate choice, not a default.
Publication
Reproducible, well-documented analyses through to peer-reviewed publication — recent work in the European Heart Journal, Leukemia, and the British Journal of Dermatology.
Observational data, done right
Real-world data is messy: treatment isn't randomised, patients drop out informatively, and naïve comparisons mislead. What sets our RWE apart is the methodology to handle it.
We bring causal-inference designs (including instrumental-variable analyses), regression standardisation, survival and competing-risks models, and multi-state modelling of patient trajectories — the same methods we develop, publish, and ship in the merlin family. For the background, see our primer What is real-world evidence?
Real-world evidence in practice
A selection of our published register-based work — the question, the approach, and what it showed.
Fair, risk-adjusted survival comparisons across hospitals and surgeons
RDA developed a multilevel-survival method that compares hospitals, surgeons, and centres fairly by standardising over a common case mix — published in BMC Medical Research Methodology, with an accompanying Stata command.
Read the case study →Does the procedure really improve survival — or is it patient selection?
Alessandro Gasparini, then at RDA, led the survival analysis on a national study of 1.2 million Medicare patients: flexible parametric models, regression standardisation, and an instrumental-variable design showed an apparent survival benefit of multiarterial grafting may be confounding rather than cause. Published in JACC.
Read the case study →Reading the whole PSA trajectory to predict survival
RDA's Sara Ekberg and Michael Crowther brought joint longitudinal–survival modelling to a study of PSA dynamics in metastatic prostate cancer — each doubling of the PSA decline rate linked to a 29% lower risk of death. Published in European Urology Oncology.
Read the case study →Mapping the path to lasting remission in lymphoma
RDA's Sara Ekberg and Michael Crowther used multi-state modelling — built on their own Stata merlin and multistate packages — to estimate the real-world chance of lasting remission after diffuse large B-cell lymphoma in 2,941 Swedish patients. Published in British Journal of Cancer.
Read the case study →The team behind our RWE work
Led by our applied-biostatistics team — decades of combined experience designing, analysing, and publishing studies on Swedish register data.
Register-based epidemiology and advanced survival methodology, with a publication record spanning haematology, oncology, rheumatology, and nephrology — focused on flexible parametric survival models, data linkage, and pharmacoepidemiology.
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Over 15 years conducting studies on Swedish register data, leading complex analyses across haematology, oncology, and cardiology, with deep expertise in navigating Sweden's national and quality registries.
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Built a comprehensive linkage of ~45,000 lymphoma patients, ~450,000 matched comparators, and their first-degree relatives from Swedish registers — focused on causal inference and reproducible research.
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