Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, NSW, Australia.
Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, NSW, Australia.
J Biomed Inform. 2019 May;93:103152. doi: 10.1016/j.jbi.2019.103152. Epub 2019 Mar 16.
Data linkage offers a powerful mechanism for examining healthcare outcomes across populations and can generate substantial robust datasets using routinely collected electronic data. However, it presents methodological challenges, especially in Australia where eight separate states and territories maintain health datasets. This study used linked data to investigate perinatal and maternal outcomes in relation to place of birth. It examined data from all eight jurisdictions regarding births planned in hospitals, birth centres and at home. Data linkage enabled the first Australia-wide dataset on birth outcomes. However, jurisdictional differences in data collection created challenges in obtaining comparable cohorts of women with similar low-risk pregnancies in all birth settings. The objective of this paper is to describe the techniques for managing previously linked data, and specifically for ensuring the resulting dataset contained only low-risk pregnancies.
This paper indicates the procedures for preparing and merging linked perinatal, inpatient and mortality data from different sources, providing technical guidance to address challenges arising in linked data study designs.
We combined data from eight jurisdictions linking four collections of administrative healthcare and civil registration data. The merging process ensured that variables were consistent, compatible and relevant to study aims. To generate comparable cohorts for all three birth settings, we developed increasingly complex strategies to ensure that the dataset eliminated women with pregnancies at risk of complications during labour and birth. It was then possible to compare birth outcomes for comparable samples, enabling specific examination of the impact of birth setting on maternal and infant safety across Australia.
Data linkage is a valuable resource to enhance knowledge about birth outcomes from different settings, notwithstanding methodological challenges. Researchers can develop and share practical techniques to address these challenges. Study findings suggest that jurisdictions develop more consistent data collections to facilitate future data linkage.
数据链接为跨人群研究医疗保健结果提供了强大的机制，并且可以使用常规收集的电子数据生成大量强大的数据集。然而，它提出了方法学上的挑战，尤其是在澳大利亚，那里有八个独立的州和地区维护着健康数据集。本研究使用链接数据研究了与分娩地点相关的围产期和产妇结局。它检查了来自所有八个司法管辖区的关于计划在医院、分娩中心和家中分娩的数据。数据链接使澳大利亚首次拥有了关于分娩结果的全面数据集。然而，数据收集方面的司法管辖区差异在所有分娩环境中获得具有相似低风险妊娠的可比妇女队列方面带来了挑战。本文的目的是描述管理以前链接数据的技术，特别是确保生成的数据集仅包含低风险妊娠。
本文指出了从不同来源准备和合并链接围产期、住院和死亡率数据的程序，为解决链接数据研究设计中出现的挑战提供了技术指导。
我们结合了来自八个司法管辖区的数据，链接了四个行政医疗保健和民事登记数据集合。合并过程确保了变量是一致的、兼容的且与研究目的相关。为了为所有三种分娩环境生成可比队列，我们制定了越来越复杂的策略，以确保数据集排除了在分娩和分娩期间有并发症风险的妊娠的妇女。然后可以比较可比样本的分娩结果，从而能够在整个澳大利亚范围内具体检查分娩环境对母婴安全的影响。
尽管存在方法学挑战，但数据链接是增强对不同环境下分娩结果的了解的宝贵资源。研究人员可以开发和共享实用技术来解决这些挑战。研究结果表明，司法管辖区应制定更一致的数据收集，以促进未来的数据链接。
