Methods Inf Med 2015; 54(04): 328-337
DOI: 10.3414/ME14-01-0093
Original Articles
Schattauer GmbH

Linked Records of Children with Traumatic Brain Injury[*]

Probabilistic Linkage without Use of Protected Health Information
T. D. Bennett
1   Pediatric Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA
2   Current address: Pediatric Critical Care, University of Colorado School of Medicine, Aurora, CO, USA
,
J. M. Dean
1   Pediatric Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA
,
H. T. Keenan
1   Pediatric Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA
,
M. H. McGlincy
3   Strategic Matching, Inc., Morrisonville, NY, USA
,
A. M. Thomas
1   Pediatric Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA
,
L. J. Cook
1   Pediatric Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA
› Institutsangaben
Weitere Informationen

Publikationsverlauf

received: 15. September 2014

accepted: 15. März 2015

Publikationsdatum:
22. Januar 2018 (online)

Preview

Summary

Objective: Record linkage may create powerful datasets with which investigators can conduct comparative effectiveness studies evaluating the impact of tests or interventions on health. All linkages of health care data files to date have used protected health information (PHI) in their linkage variables. A technique to link datasets without using PHI would be advantageous both to preserve privacy and to increase the number of potential linkages.

Methods: We applied probabilistic linkage to records of injured children in the National Trauma Data Bank (NTDB, N = 156,357) and the Pediatric Health Information Systems (PHIS, N = 104,049) databases from 2007 to 2010. 49 match variables without PHI were used, many of them administrative variables and indicators for procedures recorded as International Classification of Diseases, 9th revision, Clinical Modification codes. We validated the accuracy of the linkage using identified data from a single center that submits to both databases.

Results: We accurately linked the PHIS and NTDB records for 69% of children with any injury, and 88% of those with severe traumatic brain injury eligible for a study of intervention effectiveness (positive predictive value of 98%, specificity of 99.99%). Accurate linkage was associated with longer lengths of stay, more severe injuries, and multiple injuries.

Conclusion: In populations with substantial illness or injury severity, accurate record linkage may be possible in the absence of PHI. This methodology may enable linkages and, in turn, comparative effectiveness studies that would be unlikely or impossible otherwise.

* Supplementary material published on our web-site www.methods-online.com