scholarly journals Record linkage under suboptimal conditions for data-intensive evaluation of primary care in Rio de Janeiro, Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Claudia Medina Coeli ◽  
Valeria Saraceni ◽  
Paulo Mota Medeiros ◽  
Helena Pereira da Silva Santos ◽  
Luis Carlos Torres Guillen ◽  
...  
Keyword(s):  
Primary Care ◽  
Record Linkage ◽  
Gold Standard ◽  
Rio De Janeiro ◽  
Social Benefits ◽  
Mortality Data ◽  
Care Hospital ◽  
Data Intensive ◽  
False Match

Abstract Background Linking Brazilian databases demands the development of algorithms and processes to deal with various challenges including the large size of the databases, the low number and poor quality of personal identifiers available to be compared (national security number not mandatory), and some characteristics of Brazilian names that make the linkage process prone to errors. This study aims to describe and evaluate the quality of the processes used to create an individual-linked database for data-intensive research on the impacts on health indicators of the expansion of primary care in Rio de Janeiro City, Brazil. Methods We created an individual-level dataset linking social benefits recipients, primary health care, hospital admission and mortality data. The databases were pre-processed, and we adopted a multiple approach strategy combining deterministic and probabilistic record linkage techniques, and an extensive clerical review of the potential matches. Relying on manual review as the gold standard, we estimated the false match (false-positive) proportion of each approach (deterministic, probabilistic, clerical review) and the missed match proportion (false-negative) of the clerical review approach. To assess the sensitivity (recall) to identifying social benefits recipients’ deaths, we used their vital status registered on the primary care database as the gold standard. Results In all linkage processes, the deterministic approach identified most of the matches. However, the proportion of matches identified in each approach varied. The false match proportion was around 1% or less in almost all approaches. The missed match proportion in the clerical review approach of all linkage processes were under 3%. We estimated a recall of 93.6% (95% CI 92.8–94.3) for the linkage between social benefits recipients and mortality data. Conclusion The adoption of a linkage strategy combining pre-processing routines, deterministic, and probabilistic strategies, as well as an extensive clerical review approach minimized linkage errors in the context of suboptimal data quality.

scholarly journals Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants

2021 ◽  
pp. jech-2021-217090
Author(s):  
Tim Wilkinson ◽  
Christian Schnier ◽  
Kathryn Bush ◽  
Kristiina Rannikmäe ◽  
Ronan A Lyons ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Association Study ◽  
Hospital Admissions ◽  
Cox Regression ◽  
Mortality Data ◽  
Care Hospital ◽  
Dementia Incidence ◽  
Primary Care Hospital

BackgroundPrevious studies have suggested that some medications may influence dementia risk. We conducted a hypothesis-generating medication-wide association study to investigate systematically the association between all prescription medications and incident dementia.MethodsWe used a population-based cohort within the Secure Anonymised Information Linkage (SAIL) databank, comprising routinely-collected primary care, hospital admissions and mortality data from Wales, UK. We included all participants born after 1910 and registered with a SAIL general practice at ≤60 years old. Follow-up was from each participant’s 60th birthday to the earliest of dementia diagnosis, deregistration from a SAIL general practice, death or the end of 2018. We considered participants exposed to a medication if they received ≥1 prescription for any of 744 medications before or during follow-up. We adjusted for sex, smoking and socioeconomic status. The outcome was any all-cause dementia code in primary care, hospital or mortality data during follow-up. We used Cox regression to calculate hazard ratios and Bonferroni-corrected p values.ResultsOf 551 344 participants, 16 998 (3%) developed dementia (median follow-up was 17 years for people who developed dementia, 10 years for those without dementia). Of 744 medications, 221 (30%) were associated with dementia. Of these, 217 (98%) were associated with increased dementia incidence, many clustering around certain indications. Four medications (all vaccines) were associated with a lower dementia incidence.ConclusionsAlmost a third of medications were associated with dementia. The clustering of many drugs around certain indications may provide insights into early manifestations of dementia. We encourage further investigation of hypotheses generated by these results.

scholarly journals Real world performance of privacy preserving record linkage

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Katie Irvine ◽  
Michael Smith ◽  
Reinier De Vos ◽  
Adrian Brown ◽  
Anna Ferrante ◽  
...  
Keyword(s):  
Real World ◽  
Record Linkage ◽  
Gold Standard ◽  
Secondary Care ◽  
Personal Information ◽  
Quality Metrics ◽  
Bloom Filters ◽  
Mortality Data ◽  
Probabilistic Linkage ◽  
Linkage Quality

IntroductionPrivacy preserving record linkage (PPRL) using encoded or hashed data has potential to enable large-scale record linkage of previously inaccessible data. With limited real-world evaluation and implementation of PPRL at scale it is challenging for linkage practitioners to judiciously balance data protection with the accuracy and usability of linked datasets. Objectives and ApproachWe evaluated the performance of PPRL techniques using Bloom filters for linkage of data across primary and secondary care settings. This technique limits the need to disclose personal information for linkage activities. Primary care data included 272,202 records from 16 general practices in NSW. This was linked to 42.8 million records from a 7 year series of emergency presentations, hospitalisations and death registrations. For the purpose of evaluation, personal information was encoded within the data linkage centre. The quality of PPRL linkage was assessed against the true match status based on a gold standard probabilistic linkage using full personal identifiers. ResultsCompared to the gold standard probabilistic linkage using full personal identifiers, the PPRL techniques produced quality metrics of precision, recall and F measure in excess of 0.90. When configured to leverage pre-existing links between emergency department, hospital and mortality data, quality metrics around 0.98-0.99 were achieved. Lower rates of linkage quality were associated with missing demographic information and some residual variation in linkage quality across practices was observed. Conclusion/ImplicationsPPRL using Bloom filters is a promising technique for achieving high quality linkage across primary and secondary care in Australia. Further evaluation will assess scalability and quality in Australia but international collaborations are encouraged to more rapidly develop the evidence base and tactical approaches to support real world implementations.

scholarly journals Identifying dementia outcomes in UK Biobank: a validation study of primary care, hospital admissions and mortality data

2019 ◽  
Vol 34 (6) ◽  
pp. 557-565 ◽  
Author(s):  
Tim Wilkinson ◽  
◽  
Christian Schnier ◽  
Kathryn Bush ◽  
Kristiina Rannikmäe ◽  
...  
Keyword(s):  
Primary Care ◽  
Validation Study ◽  
Hospital Admissions ◽  
Mortality Data ◽  
Care Hospital ◽  
Uk Biobank ◽  
Primary Care Hospital

scholarly journals Concordance and timing in recording cancer events in primary care, hospital and mortality records for patients with and without psoriasis: A population-based cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254661
Author(s):  
Alex M. Trafford ◽  
Rosa Parisi ◽  
Martin K. Rutter ◽  
Evangelos Kontopantelis ◽  
Christopher E. M. Griffiths ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Linked Data ◽  
Mortality Data ◽  
Clinical Practice Research Datalink ◽  
Care Hospital ◽  
Health Records ◽  
Primary Care Hospital ◽  
Electronic Health ◽  
Risk Of Cancer

Background The association between psoriasis and the risk of cancer has been investigated in numerous studies utilising electronic health records (EHRs), with conflicting results in the extent of the association. Objectives To assess concordance and timing of cancer recording between primary care, hospital and death registration data for people with and without psoriasis. Methods Cohort studies delineated using primary care EHRs from the Clinical Practice Research Datalink (CPRD) GOLD and Aurum databases, with linkage to hospital episode statistics (HES), Office for National Statistics (ONS) mortality data and indices of multiple deprivation (IMD). People with psoriasis were matched to those without psoriasis by age, sex and general practice. Cancer recording between databases was investigated by proportion concordant, that being the presence of cancer record in both source and comparator datasets. Delay in recording cancer diagnoses between CPRD and HES records and predictors of discordance were also assessed. Results 58,904 people with psoriasis and 350,592 comparison patients were included using CPRD GOLD; whereas 213,400 people with psoriasis and 1,268,998 comparison patients were included in CPRD Aurum. For all cancer records (excluding keratinocyte), concordance between CPRD and HES was greater than 80%. Concordance for same-site cancer records was markedly lower (<68% GOLD-linked data; <72% Aurum-linked data). Concordance of non-Hodgkin lymphoma and liver cancer recording between CPRD and HES was lower for people with psoriasis compared to those without. Conclusions Concordance between CPRD and HES is poor when restricted to cancers of the same site, with greater discordance in people with psoriasis for some cancers of specific sites. The use of linked patient-level data is an important step in reducing misclassification of cancer outcomes in epidemiological studies using routinely collected electronic health records.

Assessment of Quality of Life (QoL) in Systemic Lupus Erythematosus Patients at a Tertiary Care Hospital in Egypt

2019 ◽  
Vol 15 (4) ◽  
pp. 304-311
Author(s):  
Mervat E. Behiry ◽  
Sahar A. Ahmed ◽  
Eman H. Elsebaie
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Tertiary Care ◽  
Damage Index ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Systemic Lupus

: Systemic Lupus Erythematosus (SLE) has a profound impact on quality of life. Objective: The objective of this study was to explore the quality of life among Egyptian SLE patients and to assess its relationships with demographic and clinical features. Methods: One hundred sixty-four SLE patients were recruited for this study. Demographic information; clinical parameters; disease activity, as evaluated by the systemic lupus erythematosus Disease Activity Index; and organ damage, as assessed by the systemic lupus international Collaborative Clinics/American College of Rheumatology Damage Index, were reported. Quality of life was assessed with a quality of life questionnaire specifically designed for patients with systemic lupus erythematosus; the questions are grouped in the following six domains: physical function, sociooccupational activities, symptoms, treatment, mood, and self-image. Higher values indicate poorer quality of life. Conclusion: Poor quality of life among Egyptian SLE patients and disease activity are strongly related to impaired lifestyles in these patients.

Sign in / Sign up

Export Citation Format

Share Document