Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study
Objectives To assess validity of record linkage using multiple indirect personal identifiers to identify same-patient hospitalisations and definition of episode of care (EC) due to acute coronary syndrome (ACS).Methods Using national hospital discharge data to identify all admissions due to ACS, we...
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BMJ Publishing Group
2019-12-01
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| author | Afonso Rocha Luıs Filipe Azevedo J C Silva Cardoso Thomas G Allison Alberto Freitas |
| author_facet | Afonso Rocha Luıs Filipe Azevedo J C Silva Cardoso Thomas G Allison Alberto Freitas |
| author_sort | Afonso Rocha |
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| description | Objectives To assess validity of record linkage using multiple indirect personal identifiers to identify same-patient hospitalisations and definition of episode of care (EC) due to acute coronary syndrome (ACS).Methods Using national hospital discharge data to identify all admissions due to ACS, we used six different linkage rules using indirect identifiers with increasing level of detail and compared validity against a pseudonymised unique identifier used as gold standard (GS). Contiguous hospitalisations within each matched group of hospitalizations occurring within 28 days of each other were considered one EC. We classified hospitalisations according to time between the first pair of hospitalisations as hospital transfer (HT: ≤1 day), early readmission (ER: 2–28 days) or recurrent cases (>28 days).Results There were 146 671 hospitalisations (unlinked), 121 987 ACS 28-day EC (linked GS), with 18 398 HTs (≤1 day), and 6286 ERs (≤28 days). Linkage rules using demographic and residence code variables produced linkage rates with highest validity for rule using sex, date of birth and four-digit residence code with sensitivity of 98.4 (95% CI: 98.4 to 98.5); specificity of 97.8 (95% CI: 97.6 to 98.0) and Cohen’s κ of 0.9 to detect ACS-EC, compared with GS linkage rule. Similarly, validity for HT and ER was high and of similar magnitude, with sensitivity ranging between 97.2% and 98.1%, and specificity between 98.8% and 99.9%, respectively.Conclusions Our internal linkage validation study using indirect patient identifiers will allow calibration of incidence rates and performance indicators, accounting for the effect of HT and readmissions. |
| format | Article |
| id | doaj-art-2fd6421cd1a542e294d9def4fbd63795 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-12-01 |
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| spelling | doaj-art-2fd6421cd1a542e294d9def4fbd637952024-12-01T13:35:12ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-033486Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation studyAfonso Rocha0Luıs Filipe Azevedo1J C Silva Cardoso2Thomas G Allison3Alberto Freitas4Center for Health Technology and Services Research (CINTESIS), University of Porto-Faculty of Medicine, Porto, PortugalDepartment of Health Information and Decision Sciences (CIDES) & Center for Health Technology and Services Research (CINTESIS), University of Porto-Faculty of Medicine, Porto, PortugalDepartment of Cardiology, Centro Hospitalar Universitário São João, University of Porto-Faculty of Medicine, Porto, PortugalDepartment of Cardiovascular Medicine and Cardiovascular Surgery, Mayo School of Medicine, Rochester, Minnesota, USADepartment of Health Information and Decision Sciences (CIDES) & Center for Health Technology and Services Research (CINTESIS), University of Porto-Faculty of Medicine, Porto, PortugalObjectives To assess validity of record linkage using multiple indirect personal identifiers to identify same-patient hospitalisations and definition of episode of care (EC) due to acute coronary syndrome (ACS).Methods Using national hospital discharge data to identify all admissions due to ACS, we used six different linkage rules using indirect identifiers with increasing level of detail and compared validity against a pseudonymised unique identifier used as gold standard (GS). Contiguous hospitalisations within each matched group of hospitalizations occurring within 28 days of each other were considered one EC. We classified hospitalisations according to time between the first pair of hospitalisations as hospital transfer (HT: ≤1 day), early readmission (ER: 2–28 days) or recurrent cases (>28 days).Results There were 146 671 hospitalisations (unlinked), 121 987 ACS 28-day EC (linked GS), with 18 398 HTs (≤1 day), and 6286 ERs (≤28 days). Linkage rules using demographic and residence code variables produced linkage rates with highest validity for rule using sex, date of birth and four-digit residence code with sensitivity of 98.4 (95% CI: 98.4 to 98.5); specificity of 97.8 (95% CI: 97.6 to 98.0) and Cohen’s κ of 0.9 to detect ACS-EC, compared with GS linkage rule. Similarly, validity for HT and ER was high and of similar magnitude, with sensitivity ranging between 97.2% and 98.1%, and specificity between 98.8% and 99.9%, respectively.Conclusions Our internal linkage validation study using indirect patient identifiers will allow calibration of incidence rates and performance indicators, accounting for the effect of HT and readmissions.https://bmjopen.bmj.com/content/9/12/e033486.full |
| spellingShingle | Afonso Rocha Luıs Filipe Azevedo J C Silva Cardoso Thomas G Allison Alberto Freitas Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study BMJ Open |
| title | Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study |
| title_full | Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study |
| title_fullStr | Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study |
| title_full_unstemmed | Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study |
| title_short | Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study |
| title_sort | internal deterministic record linkage using indirect identifiers for matching of same patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database a retrospective observational validation study |
| url | https://bmjopen.bmj.com/content/9/12/e033486.full |
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