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Summary of Significant accounting policies - Estimated Useful Lives of Intangible Assets (Details)
12 Months Ended
Dec. 31, 2022
Customer relationships  
Indefinite-lived Intangible Assets [Line Items]  
Amortization period 23 years
Order backlog  
Indefinite-lived Intangible Assets [Line Items]  
Amortization period 3 years
Trade names & brands  
Indefinite-lived Intangible Assets [Line Items]  
Amortization period 3 years
Patient database  
Indefinite-lived Intangible Assets [Line Items]  
Amortization period 7 years
Technology assets  
Indefinite-lived Intangible Assets [Line Items]  
Amortization period 5 years