Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
BMC Public Health. 2010 Sep 21;10:562. doi: 10.1186/1471-2458-10-562.
To assess the feasibility and quality of an anonymous linkage of 1) MONICA (MONItoring of trends and determinants in CArdiovscular disease, three waves between 1984 and 1993) data with 2) census and mortality records of the Swiss National Cohort in order to establish a mortality follow-up until 2008. Many countries feature the defect of lacking general population cohorts because they have missed to provide for follow-up information of health surveys.
Record linkage procedures were used in a multi-step approach. Kaplan-Meier curves from our data were contrasted with the survival probabilities expected from life tables for the general population, age-standardized mortality rates from our data with those derived from official cross-sectional mortality data. Cox regression models were fit to investigate the influence of covariates on survival.
97.8% of the eligible 10,160 participants (25-74y at baseline) could be linked to a census (1990: 9,737; 2000: 8,749), mortality (1,526, 1984-2008) and/or emigration record (320, 1990-2008). Linkage success did not differ by any key study characteristic. Results of survival analyses were robust to linkage step or certainty of a correct link. Loss to follow-up between 1990 and 2000 amounted to 4.7%. MONICA participants had lower mortality than the general population, but similar mortality patterns, (e.g. variation by educational level, marital status or region).
Using anonymized census and death records allowed an almost complete mortality follow-up of MONICA study participants of up to 25 years. Lower mortality compared to the general population was in line with a presumable 'healthy participant' selection in the original MONICA study. Apart from that, the derived data set reproduced known mortality patterns and showed only negligible potential for selection bias introduced by the linkage process. Anonymous record linkage was feasible and provided robust results. It can thus provide valuable information, when no cohort study is available.
评估将 1）MONICA（MONItoring of trends and determinants in CArdiovscular disease，1984 年至 1993 年期间的三个波次）数据与瑞士全国队列的人口普查和死亡率记录进行匿名链接的可行性和质量，以建立截至 2008 年的死亡率随访。许多国家都存在缺乏一般人群队列的缺陷，因为它们未能提供健康调查的随访信息。
使用多步骤方法进行记录链接程序。我们的数据中的 Kaplan-Meier 曲线与总人口的生存概率进行了对比，数据中的标准化死亡率与官方横断面死亡率数据得出的死亡率进行了对比。使用 Cox 回归模型来研究协变量对生存的影响。
在符合条件的 10160 名参与者（基线时 25-74 岁）中，有 97.8%（1990 年：9737 人；2000 年：8749 人）可以与人口普查（1990 年：9737 人；2000 年：8749 人）、死亡率（1984 年至 2008 年期间的 1526 人）和/或移民记录（1990 年至 2008 年期间的 320 人）相关联。链接成功与任何关键研究特征均无差异。生存分析的结果在链接步骤或正确链接的确定性方面都是稳健的。1990 年至 2000 年期间的随访损失为 4.7%。MONICA 参与者的死亡率低于一般人群，但死亡率模式相似（例如，受教育程度、婚姻状况或地区的变化）。
使用匿名人口普查和死亡记录，可以对 MONICA 研究参与者进行长达 25 年的几乎完整的死亡率随访。与一般人群相比，死亡率较低与原始 MONICA 研究中假定的“健康参与者”选择一致。除此之外，衍生数据集再现了已知的死亡率模式，并且仅显示出链接过程引入的选择偏差的可忽略潜力。匿名记录链接是可行的，并提供了可靠的结果。因此，当没有队列研究可用时，它可以提供有价值的信息。
