Reinforce chapter themes with free access to two journal articles for each chapter and further online readings. Select chapters will also include suggested weblinks.

Journal Article 18.1: Harron, K., Dibben, C., Boyd, J., Hjern, A., Azimaee, M., Barreto, M. L., Goldstein, H. (2017) ‘Challenges in administrative data linkage for research’, Big Data and Society 4(2): 2053951717745678.

Description: Linkage of population-based administrative data is a valuable tool for combining detailed individual-level information from different sources for research. While not a substitute for classical studies based on primary data collection, analyses of linked administrative data can answer questions that require large sample sizes or detailed data on hard-to-reach populations, and generate evidence with a high level of external validity and applicability for policy making. There are unique challenges in the appropriate research use of linked administrative data, for example with respect to bias from linkage errors where records cannot be linked or are linked together incorrectly. For confidentiality and other reasons, the separation of data linkage processes and analysis of linked data is generally regarded as best practice. However, the ‘black box’ of data linkage can make it difficult for researchers to judge the reliability of the resulting linked data for their required purposes. This article aims to provide an overview of challenges in linking administrative data for research. We aim to increase understanding of the implications of (i) the data linkage environment and privacy preservation; (ii) the linkage process itself (including data preparation, and deterministic and probabilistic linkage methods) and (iii) linkage quality and potential bias in linked data . We draw on examples from a number of countries to illustrate a range of approaches for data linkage in different contexts.

Journal Article 18.2: Tsang, C., Palmer, W., Bottle, A., Majeed, A. and Aylin, P. (2011) ‘A review of patient safety measures based on routinely collected hospital data’, American Journal of Medical Quality 27(2): 154–69.

Description: The literature on patient safety measures derived from routinely collected hospital data was reviewed to inform indicator development. MEDLINE and Embase databases and Web sites were searched. Of 1738 citations, 124 studies describing the application, evaluation, or validation of hospital-based medical error or complication of care measures were reviewed. Studies were frequently conducted in the United States (n = 88) between 2005 and 2009 (n = 77) using Agency for Healthcare Research and Quality patient safety indicators (PSIs; n = 79). The most frequently cited indicators included “postoperative hemorrhage or hematoma” and “accidental puncture and laceration.” Indicator refinement is supported by international coding algorithm translations but is hampered by data issues, including coding inconsistencies. The validity of PSIs and similar adverse event screens beyond internal measurement and the effects of organizational factors on patient harm remain uncertain. Development of PSIs in ambulatory care settings, including general practice and psychiatric care, needs consideration.