Centre for Public Health, Institute of Clinical Sciences Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, United Kingdom; UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Institute of Clinical Sciences Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, United Kingdom.
Centre for Public Health, Institute of Clinical Sciences Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, United Kingdom; UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Institute of Clinical Sciences Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, United Kingdom.
J Clin Epidemiol. 2015 Jun;68(6):684-92. doi: 10.1016/j.jclinepi.2015.01.011. Epub 2015 Jan 27.
To investigate individual, household, and country variation in consent to health record linkage.
Data from 50,994 individuals aged 16-74 years recruited to wave 1 of a large UK general purpose household survey (January 2009-December 2010) were analyzed using multilevel logistic regression models.
Overall, 70.7% of respondents consented to record linkage. Younger age, marriage, tenure, car ownership, and education were all significantly associated with consent, although there was little deviation from 70% in subgroups defined by these variables. There were small increases in consent rates in individuals with poor health when defined by self-reported long-term limiting illness [adjusted odds ratio (OR) = 1.11; 95% confidence intervals (CIs): 1.06, 1.16], less so when defined by General Health Questionnaire score (adjusted OR = 1.05; 95% CIs: 1.00, 1.10), but the range in absolute consent rates between categories was generally less than 10%. Larger differences were observed for those of nonwhite ethnicity who were 38% less likely to consent (adjusted OR = 0.62; 95% CIs: 0.59, 0.66). Consent was higher in Scotland than England (adjusted OR = 1.17; 95% CIs: 1.06, 1.29) but lower in Northern Ireland (adjusted OR = 0.56; 95% CIs: 0.50, 0.63).
The modest overall level of systematic bias in consent to record linkage provides reassurance for record linkage potential in general purpose household surveys. However, the low consent rates among nonwhite ethnic minority survey respondents will further compound their low survey participation rates. The reason for the country-level variation requires further study.
调查个人、家庭和国家在同意健康记录链接方面的差异。
使用多水平逻辑回归模型分析了 2009 年 1 月至 2010 年 12 月期间参加英国一项大型通用家庭调查第 1 波的 50994 名 16-74 岁个体的数据。
总体而言，70.7%的受访者同意进行记录链接。年轻、已婚、有房、有车和受教育程度均与同意相关，尽管在按这些变量定义的亚组中，同意率几乎没有偏离 70%。在自我报告患有长期限制疾病的个体中，健康状况较差者同意率略有增加[调整后的优势比（OR）=1.11；95%置信区间（CI）：1.06，1.16]，在根据一般健康问卷评分定义的个体中增加较少（调整后的 OR=1.05；95%CI：1.00，1.10），但类别之间的绝对同意率差异通常小于 10%。对于非白种人，差异更大，他们同意的可能性低 38%（调整后的 OR=0.62；95%CI：0.59，0.66）。与英格兰相比，苏格兰的同意率更高（调整后的 OR=1.17；95%CI：1.06，1.29），而北爱尔兰的同意率更低（调整后的 OR=0.56；95%CI：0.50，0.63）。
对健康记录链接的同意存在适度的系统偏差，这为通用家庭调查中的记录链接潜力提供了保证。然而，少数民族非白种人调查受访者的低同意率将进一步加剧他们的低调查参与率。需要进一步研究国家层面差异的原因。
