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评估在国家以患者为中心的临床研究网络PCORnet®中,隐私保护记录链接对记录重叠以及患者人口统计学和临床特征的影响。

Assessing the impact of privacy-preserving record linkage on record overlap and patient demographic and clinical characteristics in PCORnet®, the National Patient-Centered Clinical Research Network.

作者信息

Marsolo Keith, Kiernan Daniel, Toh Sengwee, Phua Jasmin, Louzao Darcy, Haynes Kevin, Weiner Mark, Angulo Francisco, Bailey Charles, Bian Jiang, Fort Daniel, Grannis Shaun, Krishnamurthy Ashok Kumar, Nair Vinit, Rivera Pedro, Silverstein Jonathan, Zirkle Maryan, Carton Thomas

机构信息

Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.

出版信息

J Am Med Inform Assoc. 2023 Feb 16;30(3):447-455. doi: 10.1093/jamia/ocac229.

Abstract

OBJECTIVE

This article describes the implementation of a privacy-preserving record linkage (PPRL) solution across PCORnet®, the National Patient-Centered Clinical Research Network.

MATERIAL AND METHODS

Using a PPRL solution from Datavant, we quantified the degree of patient overlap across the network and report a de-duplicated analysis of the demographic and clinical characteristics of the PCORnet population.

RESULTS

There were ∼170M patient records across the responding Network Partners, with ∼138M (81%) of those corresponding to a unique patient. 82.1% of patients were found in a single partner and 14.7% were in 2. The percentage overlap between Partners ranged between 0% and 80% with a median of 0%. Linking patients' electronic health records with claims increased disease prevalence in every clinical characteristic, ranging between 63% and 173%.

DISCUSSION

The overlap between Partners was variable and depended on timeframe. However, patient data linkage changed the prevalence profile of the PCORnet patient population.

CONCLUSIONS

This project was one of the largest linkage efforts of its kind and demonstrates the potential value of record linkage. Linkage between Partners may be most useful in cases where there is geographic proximity between Partners, an expectation that potential linkage Partners will be able to fill gaps in data, or a longer study timeframe.

摘要

目的

本文描述了一种隐私保护记录链接(PPRL)解决方案在全国以患者为中心的临床研究网络PCORnet®中的实施情况。

材料与方法

我们使用Datavant公司的PPRL解决方案,对网络中患者的重叠程度进行了量化,并报告了对PCORnet人群的人口统计学和临床特征进行去重分析的结果。

结果

参与响应的网络合作伙伴共有约1.7亿条患者记录,其中约1.38亿条(81%)对应唯一患者。82.1%的患者出现在单个合作伙伴处,14.7%的患者出现在两个合作伙伴处。合作伙伴之间的重叠百分比在0%至80%之间,中位数为0%。将患者的电子健康记录与理赔数据相链接后,每种临床特征的疾病患病率均有所增加,增幅在63%至173%之间。

讨论

合作伙伴之间的重叠情况各不相同,且取决于时间范围。然而,患者数据链接改变了PCORnet患者群体的患病率概况。

结论

该项目是同类中规模最大的链接工作之一,展示了记录链接的潜在价值。在合作伙伴地理位置相近、预期潜在链接合作伙伴能够填补数据空白或研究时间范围较长的情况下,合作伙伴之间的链接可能最为有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6735/9933062/e45283f845fa/ocac229f1.jpg

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