Testing for chlamydial infection: are we meeting clinical guidelines? Evidence from a state-level laboratory data linkage analysis for 15- to 29-year-olds

Sexual Health ◽  
2017 ◽  
Vol 14 (6) ◽  
pp. 507 ◽  
Author(s):  
Nicola Stephens ◽  
David Coleman ◽  
Kelly Shaw ◽  
Maree O' Sullivan ◽  
Alistair McGregor ◽  
...  
Keyword(s):  
Clinical Guidelines ◽  
Linked Data ◽  
Data Linkage ◽  
Laboratory Data ◽  
State Level ◽  
Sexually Active ◽  
Socioeconomic Indicators ◽  
Healthcare Settings ◽  
Population Prevalence ◽  
Testing Coverage

Background Clinical guidelines recommend annual chlamydia tests for all sexually active people aged 15–29 years. This study measured adherence to these guidelines and compared testing rates to the projected levels required to reduce chlamydia prevalence. Methods: All chlamydia tests conducted in Tasmania during 2012–13, for residents aged 15–29 years, were linked. Data linkage allowed individuals who had multiple tests across different healthcare settings to be counted only once each year in analyses. Rates of testing and test positivity by age, sex, rebate status and socioeconomic indicators were measured. Results: There were 31 899 eligible tests conducted in 24 830 individuals. Testing coverage was higher in females (21%, 19 404/92 685) than males (6%, 5426/98 123). Positivity was higher in males (16%, 862/5426) than females (10%, 1854/19 404). Most tests (81%, 25 803/31 899) were eligible for a rebate. Positivity was higher in females with non-rebatable tests (12%, 388/3116 compared with those eligible for a rebate (9%, 1466/16 285). More testing occurred in areas of middle disadvantage (10%, 9688/93 678) compared with least (8%, 1680/21 670) and most (10%, 7284/75 460) (both P < 0.001) disadvantaged areas. Higher test positivity was found in areas of most-disadvantage (11%, 822/7284) compared with middle- (10%, 983/9688) and least- (8%, 139/1680) disadvantaged areas. Conclusions: Chlamydia testing rates are lower than recommended levels. Sustaining the current testing rates in females aged 20–24 years may reduce population prevalence within 10 years. This study meets key priorities of national strategies for chlamydia control by providing a method of monitoring testing coverage and evidence to evaluate prevention programs.

Chlamydia retesting and retest positivity rates: results from a state-wide laboratory data linkage study in Tasmania, 2012–13

Sexual Health ◽  
2017 ◽  
Vol 14 (3) ◽  
pp. 261 ◽  
Author(s):  
Nicola Stephens ◽  
David Coleman ◽  
Kelly Shaw ◽  
Maree O'Sullivan ◽  
Alistair McGregor ◽  
...  
Keyword(s):  
Data Linkage ◽  
Safer Sex ◽  
Laboratory Data ◽  
Partner Notification ◽  
Linkage Study ◽  
Chlamydia Infection ◽  
Socioeconomic Indicators ◽  
Safer Sex Practices ◽  
Positive Results

Background Chlamydia re-infection increases the likelihood of adverse long-term sequelae. Clinical guidelines recommend retesting at 3–12 months for individuals with positive results, to detect re-infections. Retesting and test positivity levels were measured in young people who previously tested positive for chlamydia infection. Methods: All chlamydia tests conducted during 2012–13 in Tasmanian residents aged 15–29 years were linked. Retesting and retest positivity rates were calculated by sex, age, socioeconomic indicators and test timeframe. Results: Retesting rates were higher in females than males at 3 months (14.5%, n = 242/1673 vs 10%, n = 71/721) (P < 0.01) and 12 months (27%, 265/968 vs 24%, 98/410) (P = 0.24). The retesting rate was higher in females living in areas of most disadvantage (35.5%, 154/434) compared with areas of middle and least disadvantage (26% 139/534) (P < 0.01). Males were more likely than females to retest positive at 3 months (35%, 25/71 vs 23%, 55/242) (P < 0.01); retest positivity at 12 months was 32% in both sexes (males 98/140; females 265/968). Retest positivity was higher in males living in areas of least disadvantage (43%, 3/7) compared with middle (24%, 16/67) (P = 0.27) and most (27%, 10/37) (P = 0.09); and higher in females living in areas of least disadvantage (39%, 7/18) compared with middle (24%, 29/121) (P < 0.01) and most (31%, 48/154) (P = 0.02). Conclusions: Retesting rates are low in Tasmania and retest positivity is high, reinforcing the importance of promoting safer sex practices, partner notification and treatment, and retesting.

scholarly journals Vasectomy reversal and prostate cancer risk: A multi-centre collaborative demonstration project of the Intentional Population Data Linkage Network

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
James Boyd ◽  
Sean Randall ◽  
Emma Fuller
Keyword(s):  
Prostate Cancer ◽  
United Kingdom ◽  
Cancer Risk ◽  
Linked Data ◽  
Data Linkage ◽  
Prostate Cancer Risk ◽  
Population Data ◽  
Demonstration Project ◽  
The United Kingdom ◽  
Vasectomy Reversal

This first collaborative demonstration project of the International Population Data Linkage Network (IPDLN) has recently been completed. This project collated data from five data linkage centres across Australia, the United Kingdom and Canada to investigate the effect of vasectomy reversal on prostate cancer risk in vasectomized men. We discuss the study and the challenges of organising and analysing multi-centre linked data studies.

scholarly journals Enhancing Joint Replacement Outcomes Through Registry Linkage with National Health Administrative Data in Australia

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Katherine Duszynski ◽  
Stephen E Graves ◽  
Nicole Pratt ◽  
Maria Inacio ◽  
Richard De Steiger ◽  
...  
Keyword(s):  
Health Service ◽  
Administrative Data ◽  
Joint Replacement ◽  
Linked Data ◽  
Data Linkage ◽  
Service Utilisation ◽  
Prescription Data ◽  
National Data ◽  
Joint Replacement Surgery ◽  
Replacement Surgery

IntroductionMonitoring of joint replacement (JR) data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) has reduced revision rates and improved surgical practice. Outcome assessment post-arthroplasty is limited however, to revision (reoperation) surgery and mortality outcomes. The AOANJRR National Data Linkage project seeks to broaden the scope of outcomes investigation in Australia by linking registry and health administrative datasets. Objectives and ApproachUsing linked registry and administrative data, the project seeks to describe and quantify national/regional trends and variation in major complications (infection, dislocation, arthrofibrosis, chronic pain, venous thromboembolism, cardiac events), malignancy and health service utilisation (readmissions, emergency encounters and inpatient rehabilitation) following hip, knee and shoulder joint replacement surgery. Evidence will be generated on how these outcomes are associated with and vary according to patient, surgical, implant, hospital and pharmacological factors. As Australia lacks a national identifier, seven linkage agencies are probabilistically linking AOANJRR hip, knee and shoulder replacement data (1999-2017) with 20 datasets. Datasets include government-subsidised health services, procedural and prescription data. Hospital separations and emergency attendance data from Australia’s eight jurisdictions together with national cancer registry and rehabilitation service data are also planned for linkage. Linked data are maintained in a secure remote access computing environment. ResultsTo date, national Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and the Australian Cancer Database data have been linked with >900,000 AOANJRR patients, representing 607.6 million health service records (1999-2018), 467.7 million prescriptions (2002-2018) and 184,000 cancer records, respectively. Remaining linked data will be available in mid-2020. Some initial summary results across a selected range of studies will be presented. Conclusion / ImplicationsThis national data-linkage program will identify areas for improvement in joint replacement surgery and modifiable risk factors contributing to poor patient outcomes.

scholarly journals Twenty Years of Data Linkage in The Australian Longitudinal Study on Women’s Health

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Colleen Loos ◽  
Gita Mishra ◽  
Annette Dobson ◽  
Leigh Tooth
Keyword(s):  
Longitudinal Study ◽  
Data Collection ◽  
Women’S Health ◽  
Women's Health ◽  
Linked Data ◽  
Data Linkage ◽  
Data Access ◽  
National Study ◽  
Australian Longitudinal Study ◽  
Data Collections

IntroductionLinked health record collections, when combined with large longitudinal surveys, are a rich research resource to inform policy development and clinical practice across multiple sectors. Objectives and ApproachThe Australian Longitudinal Study on Women’s Health (ALSWH) is a national study of over 57,000 women in four cohorts. Survey data collection commenced in 1996. Over the past 20 years, ALSWH has also established an extensive data linkage program. The aim of this poster is to provide an overview of ALSWH’s program of regularly up-dated linked data collections for use in parallel with on-going surveys, and to demonstrate how data are made widely available to research collaborators. ResultsALSWH surveys collect information on health conditions, ageing, reproductive characteristics, access to health services, lifestyle, and socio-demographic factors. Regularly updated linked national and state administrative data collections add information on health events, health outcomes, diagnoses, treatments, and patterns of service use. ALSWH’s national linked data collections, include Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, the National Death Index, the Australian Cancer Database, and the National Aged Care Data Collection. State and Territory hospital collections include Admitted Patients, Emergency Department and Perinatal Data. There are also substudies, such as the Mothers and their Children’s Health Study (MatCH), which involves linkage to children’s educational records. ALSWH has an internal Data Access Committee along with systems and protocols to facilitate collaborative multi-sectoral research using de-identified linked data. Conclusion / ImplicationsAs a large scale Australian longitudinal multi-jurisdictional data linkage and sharing program, ALSWH is a useful model for anyone planning similar research.

scholarly journals Record Linkage Methodology for the Social Data Linkage Environment at Statistics Canada

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Colin Babyak ◽  
Abdelnasser Saidi
Keyword(s):  
Computational Complexity ◽  
Record Linkage ◽  
False Positive ◽  
Linked Data ◽  
Data Linkage ◽  
Social Data ◽  
Probabilistic Record Linkage ◽  
The Social ◽  
Data Source ◽  
Statistics Canada

ABSTRACTObjectivesThe objectives of this talk are to introduce Statistics Canada’s Social Data Linkage Environment (SDLE) and to explain the methodology behind the creation of the central depository and how both deterministic and probabilistic record linkage techniques are used to maintain and expand the environment.ApproachWe will start with a brief overview of the SDLE and then continue with a discussion of how both deterministic linkages and probabilistic linkages (using Statistic Canada’s generalized record linkage software, G-Link) have been combined to create and maintain a very large central depository, which can in turn be linked to virtually any social data source for the ultimate end goal of analysis.ResultsAlthough Canada has a population of about 36 million people, the central depository contains some 300 million records to represent them, due to multiple addresses, names, etc. Although this allows for a significant reduction in missing links, it raises the spectre of additional false positive matches and has added computational complexity which we have had to overcome.ConclusionThe combination of deterministic and probabilistic record linkage strategies has been effective in creating the central depository for the SDLE. As more and more data are linked to the environment and we continue to refine our methodology, we can now move on to the ultimate goal of the SDLE, which is to analyze this vast wealth of linked data.

scholarly journals Case Study for Stroke: National Stroke Data Linkage Program

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Monique F Kilkenny ◽  
Joosup Kim ◽  
Lachlan Dalli ◽  
Amminadab Eliakundu ◽  
Muideen Olaiya
Keyword(s):  
Linked Data ◽  
Data Linkage ◽  
Stroke Care ◽  
Aged Care ◽  
Public Hospitals ◽  
Economic Evaluations ◽  
Care Services ◽  
Linkage Program ◽  
The Impact

IntroductionStroke is a leading cause of death and disability. Since 2012, our innovative national data linkage program, has enabled the successful linkage of data from the Australian Stroke Clinical Registry (AuSCR) with national and state-based datasets to investigate the continuum of stroke care and associated outcomes. Objectives and ApproachUsing stroke as a case study, in this symposium we will describe the use of linked data to undertake clinical and economic evaluations and contribute new knowledge for policy and practice. We have undertaken a range of iterative and innovative projects linking the AuSCR (used now in >80 public hospitals across Australia with follow-up survey of patients between 90-180 days) with various administrative datasets. Linkages with the National Death Index, inpatient admissions and emergency presentations, Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), Aged Care services; Ambulance Victoria, Australian Rehabilitation Outcomes Centre and general practice network datasets (POLAR) have been achieved. ResultsThe symposium will provide case studies and results from four data linkage projects involving the AuSCR: 1) Stroke123 (NHMRC: #1034415), a study to investigate the impact of quality of acute care on admission/emergency presentations and survival; 2) PRECISE (NHMRC:#1141848), a study to evaluate models of primary care involving linkages with PBS/MBS, aged care services and admissions/emergency data; 3) AMBULANCE: a study to investigate how pre-hospital care affects acute stroke care involving linkages with the ambulance and admissions/emergency datasets; and 4) POLAR: a study to understand the long-term management of stroke involving linkages with primary health data. Conclusion / ImplicationsThe National Stroke Data Linkage Program has been visionary and remains highly contemporary in the field of linked data. A unique feature of this program is the active participation of clinicians and policy-makers to ensure the evidence generated have direct benefits for accelerating change in practice and informing policy.

Perspectives on the Value of American Society of Clinical Oncology Clinical Guidelines as Reported by Oncologists and Health Maintenance Organizations

2003 ◽  
Vol 21 (5) ◽  
pp. 937-941 ◽  
Author(s):  
Charles L. Bennett ◽  
Mark R. Somerfield ◽  
David G. Pfister ◽  
Cecilia Tomori ◽  
Sofia Yakren ◽  
...  
Keyword(s):  
Clinical Guidelines ◽  
Guideline Development ◽  
Health Maintenance Organizations ◽  
National Committee ◽  
Implementation Barriers ◽  
Services Research ◽  
Health Maintenance ◽  
Healthcare Settings ◽  
Academic Practices ◽  
American Society

Purpose: Although the American Society of Clinical Onoclogy’s (ASCO) Health Services Research (HSR) committee activities have primarily focused on clinical guideline development, little is known about the value placed on these guidelines by the desired end users. ASCO members and Health Maintenance Organizations (HMOs) were surveyed on the value and implementation of ASCO guidelines. In this article, we summarize our findings. Methods: ASCO members (n = 1500) were queried about whether they had read ASCO’s first four clinical guidelines and technology assessment; whether they agreed with the recommendations; whether they used guidelines in clinical practice; and how guidelines had affected reimbursement. HMOs (n = 131) were queried on how they identify, implement, and value the first four ASCO clinical guidelines. Results: The membership survey indicated that ASCO guidelines were read more often by physicians in private healthcare settings compared with physicians in academic practices (P < .02). Disagreement rates were low for all guidelines (range, 1% to 7%). One quarter of respondents reported that the guidelines were difficult to find and difficult to apply to the practice setting, and approximately one tenth of respondents indicated that the guidelines were difficult to evaluate, interpret, or read. The HMO survey indicated that one third of HMOs reported use of ASCO guidelines, with higher rates of usage by larger HMOs and by those with higher National Committee on Quality Assurance (NCQA) ratings. Respondent HMOs valued guidelines for various purposes and used multiple methods of guideline identification and implementation. Conclusion: ASCO guidelines are generally highly supported by physicians and HMOs. Additional studies are needed to identify implementation barriers and to see whether guidelines have resulted in improvements in healthcare.

Syphilitic hepatitis and neurosyphilis: an observational study of Danish HIV-infected individuals during a 13-year period

2019 ◽  
Vol 95 (6) ◽  
pp. 416-418
Author(s):  
Kirsten Salado-Rasmussen ◽  
Maria Wessman ◽  
Susan A Cowan ◽  
Jan Gerstoft ◽  
Terese Lea Katzenstein
Keyword(s):  
Laboratory Data ◽  
Personal Identification ◽  
Neurological Symptoms ◽  
Sexually Active ◽  
Facial Paresis ◽  
Motor Weakness ◽  
Unexplained Pain ◽  
Secondary Stage ◽  
Sex With Men ◽  
Active Patients

ObjectiveSyphilis is an STI that potentially affects any organ. Syphilitic hepatitis and neurosyphilis have been reported in both HIV-uninfected and HIV-infected individuals. The aim of this study was to investigate syphilitic hepatitis and neurosyphilis among HIV-infected individuals during a 13-year period.MethodsThis retrospective study included all HIV-infected individuals ≥18 years diagnosed with syphilis between 1 May 2004 and 31 December 2016 in Copenhagen, Denmark. We used the unique 10-digit personal identification number assigned to all individuals in Denmark to link data from two nationwide registers to identify the patients. Patient files were revised to obtain clinical and laboratory data.ResultsA total of 509 episodes of syphilis were diagnosed in 427 HIV-infected individuals attending three hospitals in Copenhagen, Denmark. The majority of the patients were men (99.5%), and the majority of men were men who have sex with men (96%). Twenty-seven patients (6%) met the criteria for neurosyphilis, and the neurological symptoms included ocular and auditory abnormalities, headache, paraesthesia, vertigo, facial paresis, motor weakness and unexplained pain in the legs. The patients with neurosyphilis were diagnosed in the secondary stage (84%) and in the early latent (8%) or late latent (8%) stage. Among the patients tested for liver affection, 41% met the criteria for syphilitic hepatitis. The patients with syphilitic hepatitis were diagnosed in the secondary stage (82%), primary stage (10%), and in the early latent (5%) or late latent (3%) stage.ConclusionsThe study emphasises that patients with syphilis, also those seen at STI clinics, should undergo a thorough clinical examination and questioning to reveal neurological symptoms. Identification of patients with neurosyphilis is crucial since these patients undergo a different treatment. The study also emphasises that syphilis should be considered as a diagnosis in sexually active patients with liver .

scholarly journals Population Data BC: Supporting population data science in British Columbia

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Tavinder Kaur Ark ◽  
Sarah Kesselring ◽  
Brent Hills ◽  
Kim McGrail
Keyword(s):  
Linked Data ◽  
Large Scale ◽  
Data Science ◽  
Data Linkage ◽  
Population Data ◽  
Cost Effective ◽  
Data Access ◽  
Well Being ◽  
Third Party ◽  
Individual Level

BackgroundPopulation Data BC (PopData) was established as a multi-university data and education resourceto support training and education, data linkage, and access to individual level, de-identified data forresearch in a wide variety of areas including human and community development and well-being. ApproachA combination of deterministic and probabilistic linkage is conducted based on the quality andavailability of identifiers for data linkage. PopData utilizes a harmonized data request and approvalprocess for data stewards and researchers to increase efficiency and ease of access to linked data.Researchers access linked data through a secure research environment (SRE) that is equipped witha wide variety of tools for analysis. The SRE also allows for ongoing management and control ofdata. PopData continues to expand its data holdings and to evolve its services as well as governanceand data access process. DiscussionPopData has provided efficient and cost-effective access to linked data sets for research. After twodecades of learning, future planned developments for the organization include, but are not limitedto, policies to facilitate programs of research, access to reusable datasets, evaluation and use of newdata linkage techniques such as privacy preserving record linkage (PPRL). ConclusionPopData continues to maintain and grow the number and type of data holdings available for research.Its existing models support a number of large-scale research projects and demonstrate the benefitsof having a third-party data linkage and provisioning center for research purposes. Building furtherconnections with existing data holders and governing bodies will be important to ensure ongoingaccess to data and changes in policy exist to facilitate access for researchers.

scholarly journals Progress with Access to Cross-jurisdictional Linked Data in Australia

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Natalie Wray ◽  
Felicity Flack ◽  
Merran Smith
Keyword(s):  
Linked Data ◽  
Human Services ◽  
Data Linkage ◽  
National Data ◽  
Central System ◽  
Application System ◽  
Online Application ◽  
Specific Project ◽  
State Territory ◽  
Multiple Jurisdictions

IntroductionAustralia is a federal, parliamentary, constitutional monarchy which consists of six states and two territories. As a result there is no single national data collection that follows individuals’ interactions with health and human services from birth to death. Therefore researchers need access to linked data from multiple jurisdictions. Objectives and ApproachThe objective of this project was to evaluate the progress of the PHRN in providing researchers access to linkage infrastructure for cross-jurisdictional and multi-jurisdictional projects. Data from the PHRN Online Application System (OAS) was analysed to determine: The number of applications for linked data received The number of jurisdictions involved in each application The number of applications involving researchers from multiple jurisdictions The number of applications involving linkage of state and Commonwealth data An analysis of peer reviewed publications resulting from the use of the infrastructure was also conducted. ResultsAustralia has a unique distributed national data linkage system which enables linkage of data both within and between jurisdictions. Each jurisdiction (state/territory and Commonwealth) has a linkage unit which provides linkage services within that jurisdiction. For cross-jurisdictional linkage, depending on the design of the specific project, the linkage is conducted either by the national data linkage unit or a combination of the national linkage unit and the state/territory data linkage units. Analysis of the data from the OAS shows an increase in the applications for cross-jurisdictional and multi-jurisdictional linked data. There is a mix of requests for only state/territory data and for state/territory/Commonwealth data. The number of national collaborations and publications has also increased. Conclusion/ImplicationsCross-jurisdictional linkage is challenging in a federated country. There are many legislative, regulatory and policy barriers. Despite these challenges, Australia has developed a national system enabling researchers to apply through a central system and for jurisdictions to work together to link and provide access to cross-jurisdictional and multi-jurisdictional data.

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