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. 2024 Mar 1;14(3):e150-e155.
doi: 10.1542/hpeds.2023-007397.

Probabilistic Linkage Creates a Novel Database to Study Bronchiolitis Care in the PICU

Brian F Flaherty  1 , Mckenna Smith  1 , Adam Dziorny  2 , Rajendu Srivastava  3   4 , Lawrence J Cook  1 , Heather T Keenan  1
Affiliations

Probabilistic Linkage Creates a Novel Database to Study Bronchiolitis Care in the PICU

Brian F Flaherty et al. Hosp Pediatr. .

Abstract

Objectives: Lack of a comprehensive database containing diagnosis, patient and clinical characteristics, diagnostics, treatments, and outcomes limits needed comparative effectiveness research (CER) to improve care in the PICU. Combined, the Pediatric Hospital Information System (PHIS) and Virtual Pediatric Systems (VPS) databases contain the needed data for CER, but limits on the use of patient identifiers have thus far prevented linkage of these databases with traditional linkage methods. Focusing on the subgroup of patients with bronchiolitis, we aim to show that probabilistic linkage methods accurately link data from PHIS and VPS without the need for patient identifiers to create the database needed for CER.

Methods: We used probabilistic linkage to link PHIS and VPS records for patients admitted to a tertiary children's hospital between July 1, 2017 to June 30, 2019. We calculated the percentage of matched records, rate of false-positive matches, and compared demographics between matched and unmatched subjects with bronchiolitis.

Results: We linked 839 of 920 (91%) records with 4 (0.5%) false-positive matches. We found no differences in age (P = .76), presence of comorbidities (P = .16), admission illness severity (P = .44), intubation rate (P = .41), or PICU stay length (P = .36) between linked and unlinked subjects.

Conclusions: Probabilistic linkage creates an accurate and representative combined VPS-PHIS database of patients with bronchiolitis. Our methods are scalable to join data from the 38 hospitals that jointly contribute to PHIS and VPS, creating a national database of diagnostics, treatment, outcome, and patient and clinical data to enable CER for bronchiolitis and other conditions cared for in the PICU.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: Dr Dziorny reports that he received funding from the American Academy of Pediatrics (AAP) to travel and speak at the 2022 AAP National Conference and Exhibition; Dr Srivastava reports support from the IPASS Patient Safety Institute, is a physician founder of the IPASS Patient Safety Institute and his equity is owned by his employer, Intermountain Healthcare, has active grants from the following federal agencies: PCORI, NIH, AHRQ, CDC (the grant funds are paid to his institution outside the submitted work), and has received monetary awards, honoraria, and travel reimbursement from multiple academic and professional organizations for teaching and consulting on quality of care, spreading evidence-based best practices in health systems and pediatric hospital medicine.

Figures

FIGURE 1
FIGURE 1
Flowchart of records. VPS records were probabilistically and deterministically (“Gold Standard”) matched to a PHIS record. In probabilistic linkage, 81/920 (9%) VPS records of patients with bronchiolitis did not match to a PHIS record with a match probability ≥0.99. In deterministic linkage, all 920 VPS records of patients with bronchiolitis matched to a PHIS record.
See this image and copyright information in PMC

References

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