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Validity of deterministic record linkage using multiple indirect personal identifiers: linking a large registry to

Soko Setoguchi¹, Ying Zhu², Jessica J Jalbert²

¹From the Division of Pharmacoepidemiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.S., J.J.J., L.A.W., C.-Y.C.); Duke Clinical Research Institute and Department of Medicine, Duke University School of Medicine, Durham, NC (S.S.); and Department of Biostatistics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.Z.). soko@post.harvard.edu.

Circulation. Cardiovascular Quality and Outcomes

|April 24, 2014

Summary

Linking patient registries with administrative databases can improve research. Record linkage using indirect identifiers like date of birth and sex achieved 95% sensitivity and 98% specificity, proving effective for epidemiological studies.

Area of Science:

Health Informatics
Epidemiology
Biostatistics

Background:

Patient registries and administrative databases are crucial for research.
Linking these datasets enhances their utility for epidemiological and comparative effectiveness studies.
Challenges exist due to the frequent lack of direct personal identifiers in registries.

Purpose of the Study:

To validate deterministic record linkage rules using indirect personal identifiers.
To assess the accuracy of linking hospitalization-level records without direct personal identifiers.
To compare linkage performance with rules using both direct and indirect identifiers.

Main Methods:

Utilized a national cardiovascular device registry and 100% Medicare inpatient data.
Developed and evaluated deterministic linkage rules using multiple indirect patient-level identifiers (date of birth, sex, admission date) and hospital ID.
Compared results against a gold standard linkage using direct and indirect identifiers.

Main Results:

Linkage rules employing 2-3 indirect identifiers and hospital ID demonstrated high validity.
Achieved a sensitivity of 95% and specificity of 98% for record linkage.
Confirmed the effectiveness of indirect identifiers in the absence of direct personal identifiers.

Conclusions:

This is the first large-scale validation of deterministic linkage rules without direct personal identifiers.
Provider information is essential for successful record linkage when direct identifiers are unavailable.
The findings support the use of indirect identifiers for robust data linkage in health research.

Keywords:

Medicare databases, factual information storage and retrieval insurance claim reporting medical record linkage medical records systems, computerized registries

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