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Business combinations - Schedule of Fair Value of Intangible Assets PRA Health Sciences Inc Acquisition (Details) - PRA Health Sciences, Inc
$ in Thousands
Jul. 01, 2021
USD ($)
Business Acquisition [Line Items]  
Estimated Fair Value $ 4,919,000
Customer relationships  
Business Acquisition [Line Items]  
Estimated Fair Value $ 3,938,000
Estimated Useful Life 23 years
Order backlog  
Business Acquisition [Line Items]  
Estimated Fair Value $ 500,000
Estimated Useful Life 3 years
Trade names  
Business Acquisition [Line Items]  
Estimated Fair Value $ 202,000
Estimated Useful Life 3 years
Patient database  
Business Acquisition [Line Items]  
Estimated Fair Value $ 168,000
Estimated Useful Life 7 years
Technology  
Business Acquisition [Line Items]  
Estimated Fair Value $ 111,000
Estimated Useful Life 5 years