Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Public Health Informatics”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed2005

Home injuries and built form--methodological issues and developments in database linkage.

BACKGROUND: The aim of this body of research is to determine whether injuries in the home are more common in particular types of housing. Previous home injuries research has tended to focus on behaviours or the provision of safety equipment to families with young children. There has been little consideration of the physical environment. This study reports methodological developments in database linkage and analysis to improve researchers abilities to utilise large administrative and clinical databases to carry out health and health services research. METHODS: The study involved linking a database of home injuries obtained from an emergency department surveillance system with an external survey of all homes in an area and population denominators for home types derived from a health service administrative database. Analysis of injury incidence by housing type was adjusted for potential biases due to deprivation and distance to hospital. For non-injured individuals data confidentiality considerations required the deprivation and distance measures be imputed. The process of randomly imputing these variables and the testing of the validity of this approach is detailed. RESULTS: There were 14,081 first injuries in 112,248 residents living in 54,081 homes over a two-year period. The imputation method worked well with imputed and observed measures in the injured group being very similar. Re-randomisation and a repeated analysis gave identical results to the first analysis. One particular housing type had a substantially elevated odds ratio for injury occurrence, OR = 2.07 (95% CI: 1.87 to 2.30). CONCLUSIONS: The method of data linkage, imputation and statistical analysis used provides a basis for improved analysis of database linkage studies.

Accidents, Home↗
PubMed2006

Validation of the Provincial Transfer Authorization Centre database: a comprehensive database containing records of all inter-facility patient transfers in the province of Ontario.

BACKGROUND: The Provincial Transfer Authorization Centre (PTAC) was established as a part of the emergency response in Ontario, Canada to the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003. Prior to 2003, data relating to inter-facility patient transfers were not collected in a systematic manner. Then, in an emergency setting, a comprehensive database with a complex data collection process was established. For the first time in Ontario, population-based data for patient movement between healthcare facilities for a population of twelve million are available. The PTAC database stores all patient transfer data in a large database. There are few population-based patient transfer databases and the PTAC database is believed to be the largest example to house this novel dataset. A patient transfer database has also never been validated. This paper presents the validation of the PTAC database. METHODS: A random sample of 100 patient inter-facility transfer records was compared to the corresponding institutional patient records from the sending healthcare facilities. Measures of agreement, including sensitivity, were calculated for the 12 common data variables. RESULTS: Of the 100 randomly selected patient transfer records, 95 (95%) of the corresponding institutional patient records were located. Data variables in the categories patient demographics, facility identification and timing of transfer and reason and urgency of transfer had strong agreement levels. The 10 most commonly used data variables had accuracy rates that ranged from 85.3% to 100% and error rates ranging from 0 to 12.6%. These same variables had sensitivity values ranging from 0.87 to 1.0. CONCLUSION: The very high level of agreement between institutional patient records and the PTAC data for fields compared in this study supports the validity of the PTAC database. For the first time, a population-based patient transfer database has been established. Although it was created during an emergency situation and data collection is dependent on front-line medical workers, the PTAC data has achieved a high level of validity, perhaps even higher than many purpose built databases created during non-emergency settings.

Database Management Systems↗
PubMed2006

Assessing record linkage between health care and Vital Statistics databases using deterministic methods.

BACKGROUND: We assessed the linkage and correct linkage rate using deterministic record linkage among three commonly used Canadian databases, namely, the population registry, hospital discharge data and Vital Statistics registry. METHODS: Three combinations of four personal identifiers (surname, first name, sex and date of birth) were used to determine the optimal combination. The correct linkage rate was assessed using a unique personal health number available in all three databases. RESULTS: Among the three combinations, the combination of surname, sex, and date of birth had the highest linkage rate of 88.0% and 93.1%, and the second highest correct linkage rate of 96.9% and 98.9% between the population registry and Vital Statistics registry, and between the hospital discharge data and Vital Statistics registry in 2001, respectively. Adding the first name to the combination of the three identifiers above increased correct linkage by less than 1%, but at the cost of lowering the linkage rate almost by 10%. CONCLUSION: Our findings suggest that the combination of surname, sex and date of birth appears to be optimal using deterministic linkage. The linkage and correct linkage rates appear to vary by age and the type of database, but not by sex.

Adolescent↗
PubMed2003

Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study.

BACKGROUND: Severe acute respiratory syndrome (SARS) has claimed 349 lives with 5,327 probable cases reported in mainland China since November 2002. SARS case fatality has varied across geographical areas, which might be partially explained by air pollution level. METHODS: Publicly accessible data on SARS morbidity and mortality were utilized in the data analysis. Air pollution was evaluated by air pollution index (API) derived from the concentrations of particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide and ground-level ozone. Ecologic analysis was conducted to explore the association and correlation between air pollution and SARS case fatality via model fitting. Partially ecologic studies were performed to assess the effects of long-term and short-term exposures on the risk of dying from SARS. RESULTS: Ecologic analysis conducted among 5 regions with 100 or more SARS cases showed that case fatality rate increased with the increment of API (case fatality = - 0.063 + 0.001 * API). Partially ecologic study based on short-term exposure demonstrated that SARS patients from regions with moderate APIs had an 84% increased risk of dying from SARS compared to those from regions with low APIs (RR = 1.84, 95% CI: 1.41-2.40). Similarly, SARS patients from regions with high APIs were twice as likely to die from SARS compared to those from regions with low APIs. (RR = 2.18, 95% CI: 1.31-3.65). Partially ecologic analysis based on long-term exposure to ambient air pollution showed the similar association. CONCLUSION: Our studies demonstrated a positive association between air pollution and SARS case fatality in Chinese population by utilizing publicly accessible data on SARS statistics and air pollution indices. Although ecologic fallacy and uncontrolled confounding effect might have biased the results, the possibility of a detrimental effect of air pollution on the prognosis of SARS patients deserves further investigation.

Air Pollutants↗
PubMed2005

The Public Health Information Network (PHIN) Preparedness initiative.

The Public Health Information Network (PHIN) Preparedness initiative strives to implement, on an accelerated pace, a consistent national network of information systems that will support public health in being prepared for public health emergencies. Using the principles and practices of the broader PHIN initiative, PHIN Preparedness concentrates in the short term on ensuring that all public health jurisdictions have, or have access to, systems to accomplish known preparedness functions. The PHIN Preparedness initiative defines functional requirements, technical standards and specifications, and a process to achieve consistency and interconnectedness of preparedness systems across public health.

Bioterrorism↗
PubMed2003

Accessibility of selected hospitals and medical procedures by means of aerial and transit network-based measures.

OBJECTIVE: This report investigates the use of linear and travelled route (transit network-based) distances in estimating the accessibility of hospitals to patients, for some selected hospital admission diagnostics. METHODS: For patients admitted to 14 public hospitals in Rio de Janeiro City, during 1996, under the ICD-9 headings "Complications of Pregnancy, Childbirth and the Puerperium" and "Disorders of the Circulatory System", average distances between the patient's district of residence and hospital of admission were calculated (both as Euclidean and as network-based distances). Data were obtained from the country's public health data processing agency. Geographic co-ordinates were obtained for districts of residence from the postal codes of the patients' residences. Distances were estimated with the TransCAD Geographical Information System, based on a map of the city transit network. There were 8654 patients admitted under the "Complications of Pregnancy" heading and 3439 under "Disorders of Circulatory System". RESULTS: Variations of up to a factor of 5.3, and up to 34 km, could be identified between linear and network estimates. CONCLUSION: While recognizing that network estimates have advantages, the literature on accessibility frequently argues that aerial estimates are a good approximation for those. The present results show that this is not necessarily the case.

Adult↗
PubMed2003

Learning from experience: privacy and the secondary use of data in health research.

Health services research must continually address the question: Under what conditions may data not collected specifically for research, such as primary medical data, be re-used for research without compromising the privacy of the data-subjects? For secondary use of data in research there are basically three options. Option A: Use personal data with consent or other assent from the data-subjects. To make this both fairer and more practical, in many circumstances broader construals of consent, or permission or approval, need to be explored and instituted. Option B: Anonymise the data, then use them. For many studies, this is the most practical and desirable option. The craft of anonymisation, including reversible anonymisation, or key-coding, needs to be developed and more fully supported under law. Option C: Use personal data without explicit consent, under a public interest mandate. Whether and how the data should be anonymised will depend on the situation. Public health mandates and protections deserve to be clarified, strengthened and extended for a variety of surveillance, registration, clinical audit, health services research and other types of investigation. Safeguards are an integral part of the research promise to the public, offer crucial reassurance and should be emphasised. For health services research, databases are core resources, and their stewardship must be cultivated.

Access to Information↗
PubMed2003

Privacy and the secondary use of data in health research in Scotland.

In response to new data protection legislation for the UK and widespread concern about its implications, the Scottish Executive set up the Confidentiality and Security Advisory Group for Scotland (CSAGS) to place the use of personal health information in a modern setting. The group affirmed the principle of consent and, more broadly, the importance of involving patients and the public in decisions about their health information. It promoted methods of acceptable anonymisation of data, and the need for good stewardship and disclosure of data uses to the greatest extent possible, where explicit individual consent and anonymisation were not practicable. They did not recommend pursuit of legislation, preferring consensus, informed debate and widespread acceptance of the proposed arrangements. The Scottish Executive is now responding to the work of CSAGS to develop systems that command public and patient confidence, promote good practice for clinicians and researchers, and preserve important public health and research functions.

Access to Information↗
PubMed2003

Privacy and the secondary use of data for health research: experience in Canada and suggested directions forward.

This paper has three parts. The first part describes developments in the use of personal information for health research in Canada, challenges in responding to new data protection legislation and the work of the Canadian Institutes of Health Research in assisting the research community to adapt to these developments. The second part critiques two aspects of the stakeholder analysis posited in William Lowrance's report: the lack of an analysis of researchers' interests as distinct from those of society at large, and the framing of privacy as an individual interest. I argue for recasting the privacy and research tension as a values conflict between two societal goods and not an individual versus a societal interest, and for explicitly acknowledging researchers' interests as data users. In so doing, there is no clear trump of privacy or research, and greater importance is placed upon the weighing of benefits and risks of individual studies to determine whether the waiving of consent for a particular study or programme of research is justified. The third part makes specific suggestions as to future ways in which data use practices may evolve. I argue the need to engage the public in deliberating the broad parameters under which personal information will be used, as the public collectively has a major stake in this issue and their input provides legitimacy for these uses of information. In addition, given the proliferation of prospectively-developed databases for research purposes, a 'systems' approach for obtaining consent for participation to replace the current study-by-study recruitment of individuals is appropriate.

Academies and Institutes↗
PubMed2003

Health research and the Data Protection Act 1998.

The 1998 Data Protection Act in the UK largely restates existing good practice: individuals have a right to know what data are held about them and why; and those processing data have a duty to proceed with fairness and transparency, maintain high data quality and keep data secure. Some health researchers have criticised the Act, seeing it as a legal minefield, unnecessary bureaucracy and interference from the European Union. This is largely based on misconceptions. Recent guidance from the Information Commissioner aims to assist researchers by advising how legal requirements can be met through anonymisation of data, attention to data-processing methods and fair collection of data. The Act provides a clear framework of rights and responsibilities that should be embraced with enthusiasm rather than with the reluctance of a person forced to carry out a meaningless chore.

Access to Information↗
PubMed2006

Health data in Ontario: taking stock and moving ahead.

Ontario has been a leader in performance-reporting in clinical areas such as surgery, cardiac care and drug use in the elderly. Data used to report on these areas are readily available for performance evaluation and are of reasonable quality. But other key areas like managing chronic disease and preventive care cannot be fully evaluated because relevant data are either unavailable or of poor quality. A focus on timely access to good quality demographic and vital statistics data would enhance our ability to evaluate components of the Ontario health system. New comprehensive primary care, laboratory services and drug prescriptions data sources are also necessary for health-system evaluation and planning. In the short term, a dedicated, centralized agency with legislative authority is proposed to move Ontario's health information agenda forward in a holistic, strategic and timely manner.

Benchmarking↗
PubMed2003

The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model.

Given the increasing incidence of chronic diseases across the world, the search for more effective strategies to prevent and manage them is essential. The use of the Chronic Care Model (CCM) has assisted healthcare teams to demonstrate effective, relevant solutions to this growing challenge. However, the current CCM is geared to clinically oriented systems, and is difficult to use for prevention and health promotion practitioners. To better integrate aspects of prevention and health promotion into the CCM, an enhanced version called the Expanded Chronic Care Model is introduced. This new model includes elements of the population health promotion field so that broadly based prevention efforts, recognition of the social determinants of health, and enhanced community participation can also be part of the work of health system teams as they work with chronic disease issues.

Canada↗
PubMed2003

Looking back, looking ahead: primary healthcare renewal in Canada.

This year's Health Care in Canada report prepared by the Canadian Institute for Health Information profiles what is changing, and what is not, in Canada's healthcare system, including a selection of findings related to this year's focus topic: primary healthcare.

Canada↗
PubMed2004

State level classification of serious mental illness: a case for a more uniform standard.

This study reports a national survey of U.S. states that was conducted from July of 1999 through March of 2001. The lack of consistent data on serious mental illness (SMI) provided the impetus for this study. Data was collected through a survey on states' definitions of SMI, on demographic information for patients with SMI, and on total annual per capita expenditures for SMI. Based on a 100% response rate, we found considerable variation among states in the definition used for SMI and the records kept on patients with SMI. This paper also involves a state-level statistical analysis of factors that may influence rates of per capita expenditures for SMI. The main finding using regression analysis was that per capita income and state definitions of mental illness that included DSM-III, DSM-IV, and ICD-9-CM diagnoses are significant and positively associated with a state's per capita expenditures for SMI. An additional finding is that accounting for all of the above factors, there still remains significant differences across major census divisions in per capita expenditures for the seriously mentally ill. Another major finding is that more consistent data collection is needed to take an epidemiological approach toward understanding the social conditions that contribute to SMI.

Acute Disease↗
PubMed2002

Using focus groups to guide development of a public health Web site.

This paper explores a project funded through the National Network of Libraries of Medicine to enhance effective use of the Internet by public health professionals. The processes and outcome of an effort to develop a statewide Web site for public health professionals are described. A series of focus groups was conducted as a preliminary data-gathering tool to evaluate the information needs of the target population. Results of the focus group provided a valuable framework upon which to build a successful schema for Web site development.

Computer User Training↗
PubMed2004

Worldwide variation in life-span sexual dimorphism and sex-specific environmental mortality rates.

In all human populations mean life span of women generally exceeds that of men, but the extent of this sexual dimorphism varies across different regions of the world. Our purpose here is to study, using global demographic and environmental data, the general tendency of this variation and local deviations from it. We used data on male and female life history traits and environmental conditions for 227 countries and autonomous territories; for each country or territory the life-span dimorphism was defined as the difference between mean life spans of women and men. The general tendency is an increase of life-span dimorphism with increasing average male-female life span; this tendency can be explained using a demographic model based on the Makeham-Gompertz equation. Roughly, the life-span dimorphism increases with the average life span because of an increase in the duration of expressing sex- and age-dependent mortality described by the second (exponential) term of the Makeham-Gompertz equation. Thus we investigated the differences in male and female environmental mortality described by the first term of the Makeham-Gompertz equation fitted to the data. The general pattern that resulted was an increase in male mortality at the highest and lowest latitudes. One plausible explanation is that specific factors tied to extreme latitudes influence males more strongly than females. In particular, alcohol consumption increases with increasing latitude and, on the contrary, infection pressures increase with decreasing latitude. This finding agrees with other observations, such as an increase in male mortality excess in Europe and Christian countries and an increase in female mortality excess in Asia and Muslim countries. An increase in the excess of female mortality may also be due to increased maternal mortality caused by an increase in fertility. However, this relation is not linear: In regions with the highest fertility (e.g., in Africa) the excess of female mortality is smaller than in regions with relatively lower fertility (e.g., in Asia). A possible explanation of this phenomenon is an evolutionary adaptation of women to the pressures of extremely high fertility by means of some reduction of their maternal mortality.

Age Factors↗