Cargando…

Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program

BACKGROUND: Linkage between health databases typically requires identifiers such as patient names and personal identification numbers. We developed and validated a record linkage strategy to combine administrative health databases without the use of patient identifiers, with application to South Afr...

Descripción completa

Detalles Bibliográficos
Autores principales: Shumba, Khumbo, Bor, Jacob, Nattey, Cornelius, Gareta, Dickman, Lauren, Evelyn, Macleod, William, Fox, Matthew P., Puren, Adrian, Mlisana, Koleka, Onoya, Dorina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Journal Experts 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246237/
https://www.ncbi.nlm.nih.gov/pubmed/37292689
http://dx.doi.org/10.21203/rs.3.rs-2893943/v1
_version_ 1785054992842883072
author Shumba, Khumbo
Bor, Jacob
Nattey, Cornelius
Gareta, Dickman
Lauren, Evelyn
Macleod, William
Fox, Matthew P.
Puren, Adrian
Mlisana, Koleka
Onoya, Dorina
author_facet Shumba, Khumbo
Bor, Jacob
Nattey, Cornelius
Gareta, Dickman
Lauren, Evelyn
Macleod, William
Fox, Matthew P.
Puren, Adrian
Mlisana, Koleka
Onoya, Dorina
author_sort Shumba, Khumbo
collection PubMed
description BACKGROUND: Linkage between health databases typically requires identifiers such as patient names and personal identification numbers. We developed and validated a record linkage strategy to combine administrative health databases without the use of patient identifiers, with application to South Africa’s public sector HIV treatment program. METHODS: We linked CD4 counts and HIV viral loads from South Africa’s HIV clinical monitoring database (TIER.Net) and the National Health Laboratory Service (NHLS) for patients receiving care between 2015–2019 in Ekurhuleni District (Gauteng Province). We used a combination of variables related to lab results contained in both databases (result value; specimen collection date; facility of collection; patient year and month of birth; and sex). Exact matching linked on exact linking variable values while caliper matching applied exact matching with linkage on approximate test dates (± 5 days). We then developed a sequential linkage approach utilising specimen barcode matching, then exact matching, and lastly caliper matching. Performance measures were sensitivity and positive predictive value (PPV); share of patients linked across databases; and percent increase in data points for each linkage approach. RESULTS: We attempted to link 2,017,290 lab results from TIER.Net (representing 523,558 unique patients) and 2,414,059 lab results from the NHLS database. Linkage performance was evaluated using specimen barcodes (available for a minority of records in TIER.net) as a “gold standard”. Exact matching achieved a sensitivity of 69.0% and PPV of 95.1%. Caliper-matching achieved a sensitivity of 75.7% and PPV of 94.5%. In sequential linkage, we matched 41.9% of TIER.Net labs by specimen barcodes, 51.3% by exact matching, and 6.8% by caliper matching, for a total of 71.9% of labs matched, with PPV=96.8% and Sensitivity = 85.9%. The sequential approach linked 86.0% of TIER.Net patients with at least one lab result to the NHLS database (N=1,450,087). Linkage to the NHLS Cohort increased the number of laboratory results associated with TIER.Net patients by 62.6%. CONCLUSIONS: Linkage of TIER.Net and NHLS without patient identifiers attained high accuracy and yield without compromising patient privacy. The integrated cohort provides a more complete view of patients’ lab history and could yield more accurate estimates of HIV program indicators.
format Online
Article
Text
id pubmed-10246237
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher American Journal Experts
record_format MEDLINE/PubMed
spelling pubmed-102462372023-06-08 Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program Shumba, Khumbo Bor, Jacob Nattey, Cornelius Gareta, Dickman Lauren, Evelyn Macleod, William Fox, Matthew P. Puren, Adrian Mlisana, Koleka Onoya, Dorina Res Sq Article BACKGROUND: Linkage between health databases typically requires identifiers such as patient names and personal identification numbers. We developed and validated a record linkage strategy to combine administrative health databases without the use of patient identifiers, with application to South Africa’s public sector HIV treatment program. METHODS: We linked CD4 counts and HIV viral loads from South Africa’s HIV clinical monitoring database (TIER.Net) and the National Health Laboratory Service (NHLS) for patients receiving care between 2015–2019 in Ekurhuleni District (Gauteng Province). We used a combination of variables related to lab results contained in both databases (result value; specimen collection date; facility of collection; patient year and month of birth; and sex). Exact matching linked on exact linking variable values while caliper matching applied exact matching with linkage on approximate test dates (± 5 days). We then developed a sequential linkage approach utilising specimen barcode matching, then exact matching, and lastly caliper matching. Performance measures were sensitivity and positive predictive value (PPV); share of patients linked across databases; and percent increase in data points for each linkage approach. RESULTS: We attempted to link 2,017,290 lab results from TIER.Net (representing 523,558 unique patients) and 2,414,059 lab results from the NHLS database. Linkage performance was evaluated using specimen barcodes (available for a minority of records in TIER.net) as a “gold standard”. Exact matching achieved a sensitivity of 69.0% and PPV of 95.1%. Caliper-matching achieved a sensitivity of 75.7% and PPV of 94.5%. In sequential linkage, we matched 41.9% of TIER.Net labs by specimen barcodes, 51.3% by exact matching, and 6.8% by caliper matching, for a total of 71.9% of labs matched, with PPV=96.8% and Sensitivity = 85.9%. The sequential approach linked 86.0% of TIER.Net patients with at least one lab result to the NHLS database (N=1,450,087). Linkage to the NHLS Cohort increased the number of laboratory results associated with TIER.Net patients by 62.6%. CONCLUSIONS: Linkage of TIER.Net and NHLS without patient identifiers attained high accuracy and yield without compromising patient privacy. The integrated cohort provides a more complete view of patients’ lab history and could yield more accurate estimates of HIV program indicators. American Journal Experts 2023-05-15 /pmc/articles/PMC10246237/ /pubmed/37292689 http://dx.doi.org/10.21203/rs.3.rs-2893943/v1 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. https://creativecommons.org/licenses/by/4.0/License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Article
Shumba, Khumbo
Bor, Jacob
Nattey, Cornelius
Gareta, Dickman
Lauren, Evelyn
Macleod, William
Fox, Matthew P.
Puren, Adrian
Mlisana, Koleka
Onoya, Dorina
Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program
title Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program
title_full Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program
title_fullStr Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program
title_full_unstemmed Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program
title_short Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program
title_sort record linkage without patient identifiers: proof of concept using data from south africa’s national hiv program
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246237/
https://www.ncbi.nlm.nih.gov/pubmed/37292689
http://dx.doi.org/10.21203/rs.3.rs-2893943/v1
work_keys_str_mv AT shumbakhumbo recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT borjacob recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT natteycornelius recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT garetadickman recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT laurenevelyn recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT macleodwilliam recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT foxmatthewp recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT purenadrian recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT mlisanakoleka recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram
AT onoyadorina recordlinkagewithoutpatientidentifiersproofofconceptusingdatafromsouthafricasnationalhivprogram