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PubMed2007

Demonstrating freedom from disease using multiple complex data sources 1: a new methodology based on scenario trees.

Current methods to demonstrate zone or country freedom from disease are based on either quantitative analysis of the results of structured representative surveys, or qualitative assessments of multiple sources of evidence (including complex non-representative sources). This paper presents a methodology for objective quantitative analysis of multiple complex data sources to support claims of freedom from disease. Stochastic scenario tree models are used to describe each component of a surveillance system (SSC), and used to estimate the sensitivity of each SSC. The process of building and analysing the models is described, as well as techniques to take into account any lack of independence between units at different levels within a SSC. The combination of sensitivity estimates from multiple SSCs into a single estimate for the entire surveillance system is also considered, again taking into account lack of independence between components. A sensitivity ratio is used to compare different components of a surveillance system. Finally, calculation of the probability of country freedom from the estimated sensitivity of the surveillance system is illustrated, incorporating the use and valuation of historical surveillance evidence.

Animal Diseases↗
PubMed1989

Data source automation: new technology for the management of patient-generated test results.

Self-monitoring of blood glucose is widely accepted by patients today, but its usefulness to clinicians has been seriously limited by our inability to interpret the patient-generated data. It is difficult or impossible to make optimal use of hand-kept diaries, no matter how compulsively kept. Patterns elude us, summaries are inaccurate, and large blocks of data are almost entirely ignored. To remedy these problems, data source automation--the automatic recording of data at their site of origin--is being applied to diabetes. Meters will measure blood glucose and memorize the result, date, and time of day. One system even allows the patient to record insulin dosage, exercise, and diet. The advantage of these systems lies in their potential for data management. Recognition of patterns of blood glucose concentration, easy longitudinal comparison of data, and aggregation of large data bases are all facilitated by computerized manipulation of the stored data. In-hospital use of glucose meters can have better documented quality control. It is possible to communicate data to physicians by telephone modem. Effective use of these systems, though, requires convenient software; and their acceptance in actual clinical practice must be demonstrated. But data management capabilities, as they are refined and brought into common use, could significantly improve diabetic management.

Autoanalysis↗
PubMed2004

A comparison of data sources for the surveillance of work-related carpal tunnel syndrome in Massachusetts.

BACKGROUND: This study examined whether a state surveillance system for work-related carpal tunnel syndrome (WR-CTS) based on workers' compensation claims (Sentinel Event Notification System for Occupational Risks, SENSOR) and the Annual Survey of Occupational Injuries and Illnesses (SOII) identified the same industries, occupations, sources of injury, and populations for intervention. METHODS: Trends in counts, rates, and female/male ratios of WR-CTS during 1994-1997, and age distributions were compared across three data sources: SENSOR, Massachusetts SOII, and National SOII. SENSOR and National SOII data on WR-CTS were compared by industry, occupation, and injury source. FINDINGS: Due to small sample size and subsequent gaps in available information, state SOII data on WR-CTS were of little use in identifying specific industries and occupations for intervention. SENSOR and National SOII data on the frequency of WR-CTS cases identified many similar occupations and industries, and both surveillance systems pointed to computer use as a risk factor for WR-CTS. Some high rate industries identified by SENSOR were not identified using National SOII rates even when national findings were restricted to take into account the distribution of the Massachusetts workforce. CONCLUSIONS: Use of national SOII data on rates of WR-CTS for identifying state industry priorities for WR-CTS prevention should be undertaken with caution. Options for improving state SOII data and use of other state data systems should be pursued.

Adult↗
PubMedDate not supplied

Investigation of an electronic emergency department information system as a data source for respiratory syndrome surveillance.

Emergency department syndromic surveillance may provide early warning of disease outbreaks due to bioterrorism or natural phenomena. The purpose of this investigation was to explore how an electronic emergency department information system could be used as a data source for respiratory syndrome surveillance. The process of data collection, entry, and transmission is described, and then a subset of data elements with potential epidemiological value is selected. The quality of the data contained in the system was evaluated by conducting a retrospective analysis of emergency department visits recorded in the system during 2001 and by reviewing clinical charts of cases with respiratory diagnoses. Diagnosis codes, discharge disposition, and demographic data were relatively complete; additional clinical data were not. Diagnosis codes were rapidly and reliably recorded. Data available in the system allows a description of emergency department visits for respiratory syndrome in terms of age, gender, location, severity of illness, and distribution in time. Encrypted data were transmitted every four hours to the health department without added work for emergency department personnel. Although significant obstacles remain, electronic emergency department information systems such as this may provide rapid, reliable data for syndromic surveillance.

Adult↗
PubMed1998

Linking multiple heterogeneous data sources to practice guidelines.

The BiliLIGHT system is a World Wide Web (Web) based system that integrates an interactive clinical practice guideline with real-time patient-data retrieval from remote heterogeneous data sources to help clinicians manage newborn jaundice at the point of care in three clinical settings. We briefly describe the system, how actual information exchange of medical data across institutional boundaries was achieved, and how the data were connected to a CPG. In particular, we examine the requirements for patient identification, exchange protocols, authentication, and a standard vocabulary.

Computer Systems↗
PubMedDate not supplied

[Hierarchies according to the level of evidence of source data, before their integration in the synthesis, in the matter of therapeutic efficacy].

The discipline therapeutic information uses the concept of the level of evidence for source data concerning therapeutic efficacy, and its ordering before integration in syntheses. In this paper we will start by considering the problems raised by the definition of the level of evidence in terms of the dimensions it covers. We have differentiated three components: clinical pertinance of the question asked, the methods used to reply and the quality of the data collected. Second, we will examine the different criteria important for each of these three dimensions. There are many criteria possible which do not all have the same weight, and thus for any non-arbitrary tool developed to enable the level of evidence to be ordered, it is necessary to know the weight of the different criteria. Thirdly, we will present the techniques used for working with multicriteria situations in econometrics which represent a methodology we propose using to apply in our context. To do so we need to build a 'reference' base for the level of evidence using 'experts' opinions which will help us to examine the weights of the different criteria. This approach, in conjunction with some epistemological and sociological considerations, may contribute to a better understanding of the different dimensions of this concept.

Clinical Trials as Topic↗
PubMed2003

BioSTORM: a system for automated surveillance of diverse data sources.

Heightened concerns about bioterrorism are forcing changes to the traditional biosurveillance-model. Public health departments are under pressure to follow multiple, non-specific, pre-diagnostic indicators, often drawn from many data sources. As a result, there is a need for biosurveillance systems that can use a variety of analysis techniques to rapidly integrate and process multiple diverse data feeds using a variety of problem solving techniques to give timely analysis. To meet these requirements, we are developing a new system called BioSTORM (Biological Spatio-Temporal Outbreak Reasoning Module).

Bioterrorism↗
PubMed2025

Climatic data sources and limitations of ecological niche models impact the estimations of historical ranges and niche overlaps in distantly related Korean salamanders.

BACKGROUND: Ecological niche models (ENMs) and analyses of niche overlap/divergence have become popular methods in ecology and evolutionary biology. These analyses rely on environmental data available from several databases. However, the influence of data sources on these analyses is rarely tested. Here, we test the impact of climatic data choice on the prediction of current and Plio-Pleistocene suitable habitats for two distantly related, but broadly sympatric, salamanders endemic to the Korean Peninsula. We ran MaxEnt separately on WorldClim and CHELSA climate data. We then hindcasted ENMs to five time periods of the Plio-Pleistocene, bracketing the estimated intraspecific divergence times for these species. We then quantified the differences in predictions between WorldClim- and CHELSA-based models. Also, given the sympatry and similar habitat requirements of the two species, we tested for niche overlaps using niche identity and background tests and tested the sensitivity of the results to climatic data choice. RESULTS: The ENMs successfully predicted contemporary suitable habitats for the two species. However, the predictions were highly sensitive to climatic data choice as well as variable combinations. The hindcasted ENMs produced contrasting predictions depending on the choice of climatic dataset and failed to predict suitable habitats for some Pleistocene time periods regardless of the climatic data choice. The niche analyses were also sensitive to climatic data choice, with results suggesting either niche overlaps or divergence depending on the climatic dataset used for the analyses. CONCLUSIONS: Our study highlights the influence of climatic data choice on the outcomes of ENMs and niche analyses. Our results also underscore the limitations of macroclimate-based ENMs, especially when the species is likely buffered from macroclimatic changes by microhabitat. We argue for the need for additional ecological, ecophysiological, and population genomic studies to better understand the range formation of these enigmatic species.

Animals↗
PubMed1999

Ascertainment of non-respiratory tuberculosis in five boroughs by comparison of multiple data sources.

The incidence of non-respiratory tuberculosis (TB) is known to be rising in many parts of the world. Examination of the ascertainment of non-respiratory TB in five Welsh boroughs by comparing multiple data sources showed that statutory notifications missed nearly half (38/81) of all cases over a period of 10 years, and illustrates an urgent need to improve surveillance.

Data Collection↗
PubMedDate not supplied

Data sources for immigration researchers.

"The [Australian] Bureau of Immigration, Multicultural and Population Research (BIMPR) was established in 1989 as an independent, professional research body within the Department of Immigration and Ethnic Affairs (DIEA).... The BIMPRs statistical activities include conducting its own surveys as well as acquiring and analysing data from other sources, primarily the Australian Bureau of Statistics (ABS). Set out [in this article] is information about the major sources of data used in BIMPR research."

Australia↗
PubMed2004

[Consistency between data sources and inter-observer reliability in the Study on Neonatal and Perinatal Morbidity and Mortality and Care in the City of Rio de Janeiro].

The objective of this study was to evaluate the quality of data in the research project entitled "Study on Neonatal and Perinatal Morbidity and Mortality and Care in the City of Rio de Janeiro", analyzing the completeness of patient records, inter-observer reliability, and concordance of collected data. The study interviewed a sample of 10,072 post-partum women, corresponding to 10.0% of the deliveries in the City of Rio de Janeiro. This article analyzed the concordance between data on patient records and the reproducibility of questionnaires by mean of rest/ retest, using common and prevalence-adjusted Kappa as well as the intra-class correlation coefficient. Losses totaled 4.5%, and the proportion of unknown data on patient records varied from 3.0 to 90.0%. Lower proportions were concentrated in the neonatal assessment and higher ones in the data on maternal hospital admission. There was a high concordance between the data reported by the mother and that written on the patient record, with the Kappa varying from 0.77 to 0.96. In the test/retest verification, Kappa varied from 0.61 to 0.94. This study demonstrated a high inter-observer reliability as well as reliability between the different data sources (interviewee and patient record).

Brazil↗
PubMed2005

The integrated epidemiologic profile: using multiple data sources in developing profiles to inform HIV prevention and care planning.

HIV/AIDS epidemiologic profiles describe the HIV/AIDS epidemic among state and local populations. The Centers for Disease Control and Prevention and the Health Resources Services Administration collaborated to develop one set of guidelines for developing epidemiologic profiles that would serve as the basis for both prevention and care planning. The Integrated Guidelines for Developing Epidemiologic Profiles was published in 2003. Profiles based on these guidelines describe the epidemic in terms of sociodemographic, geographic, behavioral, and clinical characteristics and should include enough data sources (e.g., sexually transmitted disease, tuberculosis, behavioral, and care-related data) to allow users to make informed, evidenced-based decisions. Development and use of these epidemiologic profiles should lead to more effective prevention and care planning and contribute to objective measures of the impact and outcomes of programs, supported by both federal agencies.

Data Collection↗
PubMed2005

Availability of pediatric emergency visit data from existing data sources.

OBJECTIVES: To determine the availability and completeness of selected data elements from administrative and clinical sources for emergency department (ED) visits in a national pediatric research network. METHODS: This was a retrospective study of 25 EDs in the Pediatric Emergency Care Applied Research Network. Data were obtained from two sources at each ED: 1) extant electronic administrative data for all visits during a 12-month period in 2002 and 2) data abstracted from medical records by trained abstractors for visits during ten randomly selected days over a three-month period in 2003. Epidemiologic data were obtained for all visits and additional clinical data for patients with two target conditions: asthma and fractures. RESULTS: A total of 749,036 visits were analyzed from administrative sources and 12,756 medical records abstracted. Data availability varied by element, method of capture, and site. From administrative sources, data on insurance type were the most complete (1.3% overall missing; range, 0%-18.5% for individual sites), whereas mode of arrival (25.5% missing) and triage time (65.3%) were the least complete. Disposition was missing in only 1.2% of medical records overall (range, 0%-5%) and diagnosis was missing in 3% (range, 0%-16%); these were missing from 14.4% and 10.5%, respectively, of administrative sources. Among visits with injury diagnoses, E-codes were missing in 27% of cases. For patients with asthma (n = 861), documentation of specific elements of the clinical examination by nurses and physicians was also variable. CONCLUSIONS: Data elements important in emergency medical care for children are frequently missing in existing administrative and medical record sources; completeness varies widely across EDs. Researchers must be aware of these limitations in the use of existing data when planning studies.

Data Collection↗
PubMedDate not supplied

Fluoride and dental caries: two different statistical approaches to the same data source.

A recent analysis of data from earlier papers on the relationship between dental caries and drinking water fluoride concentration suggested that the commonly accepted inverse relationship did not exist. Our reanalysis of those data, however, confirms the well-known association between fluoride concentration and dental caries. It also shows that the contrary result arose misleadingly from three simultaneous methodological errors: use of a unifactorial instead of a multifactorial model; omission of or over-aggregation of some data, and analysis of homoscedastic probits instead of heteroscedastic counts.

Data Interpretation, Statistical↗
PubMed2005

Monitoring cause-specific adult mortality in developing countries: a comparison of data sources for Addis Ababa and its implications for policy and research.

Hospital statistics of causes of death for developing countries may be biased when the utilization of hospital services is low or selective. Using Addis Ababa, Ethiopia as an example, we argue that hospital data can be useful for demonstrating general cause-specific mortality patterns. In addition, a comparison of hospital statistics with data from a surveillance of burials allows for the identification of weaknesses in health services provision. We find a low level of hospital services utilization during terminal illness. Despite similarities in the cause of death structure in the different data sources, hospital statistics under-estimate the prevalence of infectious diseases. In addition, we identify an important gender bias in the utilization of health services in the direction of males being significantly more likely to die in medical facilities than females.

Accidents↗
PubMed2004

Validating electronic source data in clinical trials.

The clinical trials industry relies heavily on paper-based source documents as the foundation for the collection of its clinical research data from human subjects and medical records. This focus on paper documents has been prevalent throughout the history of clinical trials conduct, even as computing solutions advanced throughout the past 20 years. With the advent of additional electronic capabilities recently with the growth of Internet-based products to enhance business operations in many fields, the clinical trials industry remains uniquely behind most other industries in electronic technology adoptions. Valid reasons exist for the slow growth of technology adoptions in clinical trial activities, but there are now discussions about how to use technology more effectively in clinical trial conduct. One area of enhanced clinical trial conduct is believed to be available by moving from paper-based source documents to electronic source documents, that is, eliminating paper from clinical data capture, and collecting the information initially in a computer system. An important concern in moving to electronic source data is the validation of such data. This paper summarizes the history of clinical data capture through paper and electronic advancements to date and identifies three reasons for the slow movement to more electronic source data. The paper then illustrates two methods for the validation of electronic source data.

Clinical Trials as Topic↗
PubMed2000

The use of partially measured source data in near-field acoustical holography based on the BEM

In applying the conformal near-field acoustical holography (NAH) to actual source identification problems, it is often possible to determine the velocity at certain points of the source surface in advance. This partially known velocity data would reduce the problem size and permit better reconstruction accuracy. In this paper, the effectiveness of using partially measured source data in the conformal NAH is investigated, which uses the boundary element method. A vibro-acoustic transfer matrix and measured field pressure data, which is involved with the boundary integral equation, are reorganized in order to deal with the partially measured surface velocities. For a baffled vibrating panel, simulations were performed by varying the number of velocity-known nodes. In addition, the effect of measurement error is investigated for two extreme positioning methods of velocity-known nodes. Without regularization, the reconstructed error can be reduced considerably by employing some of the source data and this error can be further reduced by increasing those surface points. However, the velocity reconstruction error is not reduced substantially when the number of velocity-known nodes is less than 30%-40% of the total nodes. The reduction in the reconstruction error is not large if the regularization technique is applied to the restored field.

Journal Article↗
PubMed2005

Estimating the mortality rate of hepatitis C using multiple data sources.

The New York State hospital discharge database and the multiple cause-of-death file were used to estimate the mortality rate of hepatitis C in New York State excluding New York City in 1997. The mortality rate with hepatitis C was severely underestimated when each data source was used alone. Applying the capture recapture method using the hospital discharge database and the multiple cause-of-death file appears to be an efficient method to estimate the mortality rate with hepatitis C.

Adult↗