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Doherty DA, Tong SYC, Reilly J, Shrapnel J, McDonald S, Ahern S, Harris I, Tam CS, Brennan AL, Hodgson C, Wilcox L, Balagurunathan A, Butcher BE, Reid CM. Registry randomised trials: a methodological perspective. BMJ Open 2023; 13:e068057. [PMID: 36858472 PMCID: PMC9980340 DOI: 10.1136/bmjopen-2022-068057] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Registry randomised clinical trials (RRCTs) have the potential to provide pragmatic answers to important clinical questions. RRCTs can be embedded into large population-based registries or smaller single site registries to provide timely answers at a reduced cost compared with traditional randomised controlled trials. RRCTs can take a number of forms in addition to the traditional individual-level randomised trial, including parallel group trials, platform or adaptive trials, cluster randomised trials and cluster randomised stepped-wedge trials. From an implementation perspective, initially it is advantageous to embed RRCT into well-established registries as these have typically already overcome any issues with end point validation and adjudication. With advances in data linkage and data quality, RRCTs can play an important role in answering clinical questions in a pragmatic, cost-effective way.
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Affiliation(s)
- Dorota A Doherty
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Biostatistics and Research Design Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Steven Y C Tong
- The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Menzies School of Health Research, Casuarina, Nothern Territory, Australia
| | - Jennifer Reilly
- Anaesthesiology & Perioperative Medicine, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jane Shrapnel
- The Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Stephen McDonald
- Central Northern Adelaide Dialysis, The University of Adelaide, Adelaide, South Australia, Australia
- Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
| | - Susannah Ahern
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ian Harris
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, New South Wales, Australia
| | - Charmaine S Tam
- Northern Clinical School, Centre for Translational Data Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Angela L Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Carol Hodgson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Leonie Wilcox
- Australasian Bone Marrow Transplant Recipient Registry, St Vincent's Health Australia Ltd, Sydney, New South Wales, Australia
| | | | - Belinda E Butcher
- WriteSource Medical Pty Ltd, Lane Cove, New South Wales, Australia
- University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
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Li X, Xu H, Grannis S. The Data-Adaptive Fellegi-Sunter Model for Probabilistic Record Linkage: Algorithm Development and Validation for Incorporating Missing Data and Field Selection. J Med Internet Res 2022; 24:e33775. [PMID: 36173664 PMCID: PMC9562057 DOI: 10.2196/33775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 05/16/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Quality patient care requires comprehensive health care data from a broad set of sources. However, missing data in medical records and matching field selection are 2 real-world challenges in patient-record linkage. Objective In this study, we aimed to evaluate the extent to which incorporating the missing at random (MAR)–assumption in the Fellegi-Sunter model and using data-driven selected fields improve patient-matching accuracy using real-world use cases. Methods We adapted the Fellegi-Sunter model to accommodate missing data using the MAR assumption and compared the adaptation to the common strategy of treating missing values as disagreement with matching fields specified by experts or selected by data-driven methods. We used 4 use cases, each containing a random sample of record pairs with match statuses ascertained by manual reviews. Use cases included health information exchange (HIE) record deduplication, linkage of public health registry records to HIE, linkage of Social Security Death Master File records to HIE, and deduplication of newborn screening records, which represent real-world clinical and public health scenarios. Matching performance was evaluated using the sensitivity, specificity, positive predictive value, negative predictive value, and F1-score. Results Incorporating the MAR assumption in the Fellegi-Sunter model maintained or improved F1-scores, regardless of whether matching fields were expert-specified or selected by data-driven methods. Combining the MAR assumption and data-driven fields optimized the F1-scores in the 4 use cases. Conclusions MAR is a reasonable assumption in real-world record linkage applications: it maintains or improves F1-scores regardless of whether matching fields are expert-specified or data-driven. Data-driven selection of fields coupled with MAR achieves the best overall performance, which can be especially useful in privacy-preserving record linkage.
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Affiliation(s)
- Xiaochun Li
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, The Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States
| | - Huiping Xu
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, The Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States
| | - Shaun Grannis
- Data and Analytics, Regenstrief Institute Inc., Indiana University School of Medicine, Indianapolis, IN, United States
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Brown AP, Randall SM. Secure Record Linkage of Large Health Data Sets: Evaluation of a Hybrid Cloud Model. JMIR Med Inform 2020; 8:e18920. [PMID: 32965236 PMCID: PMC7542414 DOI: 10.2196/18920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/02/2020] [Accepted: 08/23/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The linking of administrative data across agencies provides the capability to investigate many health and social issues with the potential to deliver significant public benefit. Despite its advantages, the use of cloud computing resources for linkage purposes is scarce, with the storage of identifiable information on cloud infrastructure assessed as high risk by data custodians. OBJECTIVE This study aims to present a model for record linkage that utilizes cloud computing capabilities while assuring custodians that identifiable data sets remain secure and local. METHODS A new hybrid cloud model was developed, including privacy-preserving record linkage techniques and container-based batch processing. An evaluation of this model was conducted with a prototype implementation using large synthetic data sets representative of administrative health data. RESULTS The cloud model kept identifiers on premises and uses privacy-preserved identifiers to run all linkage computations on cloud infrastructure. Our prototype used a managed container cluster in Amazon Web Services to distribute the computation using existing linkage software. Although the cost of computation was relatively low, the use of existing software resulted in an overhead of processing of 35.7% (149/417 min execution time). CONCLUSIONS The result of our experimental evaluation shows the operational feasibility of such a model and the exciting opportunities for advancing the analysis of linkage outputs.
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Affiliation(s)
| | - Sean M Randall
- Centre for Data Linkage, Curtin University, Bentley, Australia
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Abstract
OBJECTIVES Clinical Research Informatics (CRI) declares its scope in its name, but its content, both in terms of the clinical research it supports-and sometimes initiates-and the methods it has developed over time, reach much further than the name suggests. The goal of this review is to celebrate the extraordinary diversity of activity and of results, not as a prize-giving pageant, but in recognition of the field, the community that both serves and is sustained by it, and of its interdisciplinarity and its international dimension. METHODS Beyond personal awareness of a range of work commensurate with the author's own research, it is clear that, even with a thorough literature search, a comprehensive review is impossible. Moreover, the field has grown and subdivided to an extent that makes it very hard for one individual to be familiar with every branch or with more than a few branches in any depth. A literature survey was conducted that focused on informatics-related terms in the general biomedical and healthcare literature, and specific concerns ("artificial intelligence", "data models", "analytics", etc.) in the biomedical informatics (BMI) literature. In addition to a selection from the results from these searches, suggestive references within them were also considered. RESULTS The substantive sections of the paper-Artificial Intelligence, Machine Learning, and "Big Data" Analytics; Common Data Models, Data Quality, and Standards; Phenotyping and Cohort Discovery; Privacy: Deidentification, Distributed Computation, Blockchain; Causal Inference and Real-World Evidence-provide broad coverage of these active research areas, with, no doubt, a bias towards this reviewer's interests and preferences, landing on a number of papers that stood out in one way or another, or, alternatively, exemplified a particular line of work. CONCLUSIONS CRI is thriving, not only in the familiar major centers of research, but more widely, throughout the world. This is not to pretend that the distribution is uniform, but to highlight the potential for this domain to play a prominent role in supporting progress in medicine, healthcare, and wellbeing everywhere. We conclude with the observation that CRI and its practitioners would make apt stewards of the new medical knowledge that their methods will bring forward.
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Affiliation(s)
- Anthony Solomonides
- Outcomes Research Network, Research Institute, NorthShore University HealthSystem, Evanston, IL, USA
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Boyd JH, Randall SM, Brown AP, Maller M, Botes D, Gillies M, Ferrante A. Population Data Centre Profiles: Centre for Data Linkage. Int J Popul Data Sci 2020; 4:1139. [PMID: 32935041 PMCID: PMC7473267 DOI: 10.23889/ijpds.v4i2.1139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The Centre for Data Linkage (CDL) was established at Curtin University, Western Australia, to develop infrastructure to enable cross-jurisdictional record linkage in Australia. The CDL’s operating model makes use of the ‘separation principle’, with content data typically provided to researchers directly by the data custodian; jurisdictional linkage where available are used within the linkage process. Along with conducting record linkage, the team has also invested in establishing a research programme in record linkage methodology and in developing modern record linkage software which can handle the size and complexity of today’s workloads. The Centre has been instrumental in the development of practical methods for privacy-preserving record linkage, with this methodology now regularly used for real-world linkages. While the promise of a nation-wide linkage system in Australia has yet to be met, distributed models provide a potential solution.
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Affiliation(s)
- J H Boyd
- Centre for Data Linkage, School of Public Health, Curtin University.,Department of Public Health, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University
| | - S M Randall
- Centre for Data Linkage, School of Public Health, Curtin University
| | - A P Brown
- Centre for Data Linkage, School of Public Health, Curtin University
| | - M Maller
- Centre for Data Linkage, School of Public Health, Curtin University
| | - D Botes
- Centre for Data Linkage, School of Public Health, Curtin University
| | - M Gillies
- Centre for Data Linkage, School of Public Health, Curtin University
| | - A Ferrante
- Centre for Data Linkage, School of Public Health, Curtin University
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Brown AP, Randall SM, Boyd JH, Ferrante AM. Evaluation of approximate comparison methods on Bloom filters for probabilistic linkage. Int J Popul Data Sci 2019; 4:1095. [PMID: 32935029 PMCID: PMC7482522 DOI: 10.23889/ijpds.v4i1.1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The need for increased privacy protection in data linkage has driven the development of privacy-preserving record linkage (PPRL) techniques. A popular technique using Bloom filters with cryptographic analyses, modifications, and hashing variations to optimise privacy has been the focus of much research in this area. With few applications of Bloom filters within a probabilistic framework, there is limited information on whether approximate matches between Bloom filtered fields can improve linkage quality. OBJECTIVES In this study, we evaluate the effectiveness of three approximate comparison methods for Bloom filters within the context of the Fellegi-Sunter model of recording linkage: Sørensen-Dice coefficient, Jaccard similarity and Hamming distance. METHODS Using synthetic datasets with introduced errors to simulate datasets with a range of data quality and a large real-world administrative health dataset, the research estimated partial weight curves for converting similarity scores (for each approximate comparison method) to partial weights at both field and dataset level. Deduplication linkages were run on each dataset using these partial weight curves. This was to compare the resulting quality of the approximate comparison techniques with linkages using simple cut-off similarity values and only exact matching. RESULTS Linkages using approximate comparisons produced significantly better quality results than those using exact comparisons only. Field level partial weight curves for a specific dataset produced the best quality results. The Sørensen-Dice coefficient and Jaccard similarity produced the most consistent results across a spectrum of synthetic and real-world datasets. CONCLUSION The use of Bloom filter similarity comparisons for probabilistic record linkage can produce linkage quality results which are comparable to Jaro-Winkler string similarities with unencrypted linkages. Probabilistic linkages using Bloom filters benefit significantly from the use of similarity comparisons, with partial weight curves producing the best results, even when not optimised for that particular dataset.
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Affiliation(s)
- AP Brown
- Centre for Data Linkage, Curtin University, Western Australia, Perth, Australia
| | - SM Randall
- Centre for Data Linkage, Curtin University, Western Australia, Perth, Australia
| | - JH Boyd
- Centre for Data Linkage, Curtin University, Western Australia, Perth, Australia
| | - AM Ferrante
- Centre for Data Linkage, Curtin University, Western Australia, Perth, Australia
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Randall SM, Brown AP, Ferrante AM, Boyd JH. Privacy preserving linkage using multiple match-keys. Int J Popul Data Sci 2019; 4:1094. [PMID: 32935028 PMCID: PMC7482515 DOI: 10.23889/ijpds.v4i1.1094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Available and practical methods for privacy preserving linkage have shortcomings: methods utilising anonymous linkage codes provide limited accuracy while methods based on Bloom filters have proven vulnerable to frequency-based attacks. Objectives In this paper, we present and evaluate a novel protocol that aims to meld both the accuracy of the Bloom filter method with the privacy achievable through the anonymous linkage code methodology. Methods The protocol involves creating multiple match-keys for each record, with the composition of each match-key depending on attributes of the underlying datasets being compared. The protocol was evaluated through de-duplication of four administrative datasets and two synthetic datasets; the ‘answers’ outlining which records belonged to the same individual were known for each dataset. The results were compared against results achieved with un-encoded linkage and other privacy preserving techniques on the same datasets. Results The multiple match-key protocol presented here achieved high quality across all datasets, performing better than record-level Bloom filters and the SLK, but worse than field-level Bloom filters. Conclusion The presented method provides high linkage quality while avoiding the frequency based attacks that have been demonstrated against the Bloom filter approach. The method appears promising for real world use.
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Affiliation(s)
- S M Randall
- Curtin University, Western Australia, Perth, Australia
| | - A P Brown
- Curtin University, Western Australia, Perth, Australia
| | - A M Ferrante
- Curtin University, Western Australia, Perth, Australia
| | - J H Boyd
- Curtin University, Western Australia, Perth, Australia
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Harron K, Dibben C, Boyd J, Hjern A, Azimaee M, Barreto ML, Goldstein H. Challenges in administrative data linkage for research. BIG DATA & SOCIETY 2017; 4:2053951717745678. [PMID: 30381794 PMCID: PMC6187070 DOI: 10.1177/2053951717745678] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Linkage of population-based administrative data is a valuable tool for combining detailed individual-level information from different sources for research. While not a substitute for classical studies based on primary data collection, analyses of linked administrative data can answer questions that require large sample sizes or detailed data on hard-to-reach populations, and generate evidence with a high level of external validity and applicability for policy making. There are unique challenges in the appropriate research use of linked administrative data, for example with respect to bias from linkage errors where records cannot be linked or are linked together incorrectly. For confidentiality and other reasons, the separation of data linkage processes and analysis of linked data is generally regarded as best practice. However, the 'black box' of data linkage can make it difficult for researchers to judge the reliability of the resulting linked data for their required purposes. This article aims to provide an overview of challenges in linking administrative data for research. We aim to increase understanding of the implications of (i) the data linkage environment and privacy preservation; (ii) the linkage process itself (including data preparation, and deterministic and probabilistic linkage methods) and (iii) linkage quality and potential bias in linked data. We draw on examples from a number of countries to illustrate a range of approaches for data linkage in different contexts.
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Affiliation(s)
- Katie Harron
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Chris Dibben
- Institute of Geography and the Lived Environment, University of Edinburgh, Edinburgh, UK
| | - James Boyd
- Centre for Population Health Research, Curtin University, Perth, Australia
| | - Anders Hjern
- CHESS Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | | | - Mauricio L Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, CEP 41745-715 Salvador-Bahia, Brazil
| | - Harvey Goldstein
- Graduate School of Education, University of Bristol, Bristol, UK, and UCL Great Ormond Street Institute of Child Health, London, UK
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