Bobeth Christoph, Tol Kees Kleihues-van, Rößler Martin, Bierbaum Veronika, Gerken Michael, Günster Christian, Dröge Patrik, Ruhnke Thomas, Klinkhammer-Schalke Monika, Schmitt Jochen, Schoffer Olaf
Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany.
Arbeitsgemeinschaft Deutscher Tumorzentren e.V. (ADT), Berlin, Germany.
Gesundheitswesen. 2023 Mar;85(S 02):S154-S161. doi: 10.1055/a-1984-0085. Epub 2023 Mar 20.
The aim of the project "Effectiveness of care in oncological centres" (WiZen), funded by the innovation fund of the federal joint committee, is to investigate the effectiveness of certification in oncology. The project uses nationwide data from the statuory health insurance AOK and data from clinical cancer registries from three different federal states from 2006-2017. To combine the strengths of both data sources, these will be linked for eight different cancer entities in compliance with data protection regulations.
Data linkage was performed using indirect identifiers and validated using the health insurance's patient ID ("Krankenversichertennummer") as a direct identifier and gold standard. This enables quantification of the quality of different linkage variants. Sensitivity and specificity as well as hit accuracy and a score addressing the quality of the linkage were used as evaluation criteria. The distributions of relevant variables resulting from the linkage were validated against the original distributions in the individual datasets.
Depending on the combination of indirect identifiers, we found a range of 22,125 to 3,092,401 linkage hits. An almost perfect linkage could be achieved by combining information on cancer type, date of birth, gender and postal code. A total of 74,586 one-to-one linkages were achieved with these characteristics. The median hit quality for the different entities was more than 98%. In addition, both the age and sex distributions and the dates of death, if any, showed a high degree of agreement.
SHI and cancer registry data can be linked with high internal and external validity at the individual level. This robust linkage enables completely new possibilities for analysis through simultaneous access to variables from both data sets ("the best of both worlds"): Information on the UICC stage that stems from the registries can now be combined, for instance, with comorbidities from the SHI data at the individual level. Due to the use of readily available variables and the high success of the linkage, our procedure constitutes a promising method for future linkage processes in health care research.
由联邦联合委员会创新基金资助的“肿瘤中心护理效果”（WiZen）项目旨在研究肿瘤学认证的有效性。该项目使用了法定健康保险AOK的全国性数据以及来自三个不同联邦州2006 - 2017年临床癌症登记处的数据。为了结合这两个数据源的优势，将根据数据保护规定对八个不同的癌症实体进行数据链接。
使用间接标识符进行数据链接，并使用健康保险的患者ID（“Krankenversichertennummer”）作为直接标识符和黄金标准进行验证。这使得能够对不同链接变体的质量进行量化。使用敏感性和特异性以及匹配准确性和一个解决链接质量的分数作为评估标准。将链接产生的相关变量的分布与各个数据集中的原始分布进行验证。
根据间接标识符的组合，我们发现链接匹配数在22,125至3,092,401之间。通过结合癌症类型、出生日期、性别和邮政编码等信息，可以实现几乎完美的链接。利用这些特征总共实现了74,586个一对一的链接。不同实体的匹配质量中位数超过98%。此外，年龄和性别分布以及死亡日期（如果有）显示出高度一致性。
法定健康保险数据和癌症登记处数据可以在个体层面以较高的内部和外部有效性进行链接。这种稳健的链接通过同时访问两个数据集的变量，为全新的分析提供了可能性（“两全其美”）：例如，现在可以将来自登记处的国际抗癌联盟（UICC）分期信息与法定健康保险数据中的个体合并症信息相结合。由于使用了现成的变量且链接成功率高，我们的方法构成了医疗保健研究未来链接过程的一种有前景的方法。
