In Brazil, quality A garantia de uma informação de qualidade é condição essencial para a análise objetiva da situação sanitária, para a tomada de decisões baseadas em evidências e para a programação de ações de saúde 1 .Demonstrando a importância dada à qualidade da informação, o Fundo Monetário Internacional (FMI) relaciona em sua página da Internet as iniciativas de 18 países para melhoria das estatísticas econômicas e disponibiliza um modelo para aprimoramento e avaliação das informações: Data Quality Assessment Framework (DQAF. http://desbb.imf.org/Applications/web/dqrs/ dqrsapproaches, acessado em 27/Abr/2007). O escritório de estatística da comunidade européia (Eurostat) adaptou esse modelo para os países europeus, criando o Quality Declaration of the European Statistics System. Na área de tecnologia da informação o desenvolvimento de metodologias para avaliação da qualidade dos bancos de REVISÃO REVIEW

The results of this review show that, in general, individuals tend to consent to the use of their data for record linkage, with exceptions in specific populations or minorities. The authors believe that this, as well as the cited literature, lends support to policies that, while keeping relevant ethical controls in place, do not require individual informed consent for each and every study that relies on secondary data.

The regulation of specialist medical appointments represents one of the problematic areas of the Brazilian Public Health System. In this regulation process, 2 issues stand out: 1) which patients should have the highest attendance priority, and 2) which service suppliers can best resolve the specific health problem of a patient? Based on the consideration of the existing Brazilian context in the field of medical assistance, this study proposes a model designed to aid regulation centers deal with the decisions related to the process of allocating specialist medical appointments. The model integrates multicriteria decision analysis and linear programming for the specialist medical appointment allocation, in which the allocation of patients is defined as a function of the relative significance of a set of criteria related to the notion of effectiveness of the specialist medical care and the capability of the accredited specialist health care units. The integrated model was implemented in a computer-based system and validated using cardiology and vein surgery data from the regulation center in Porto Alegre, Brazil. The validated computational system was applied to mammography services in another regulation center. The system successfully implemented a prioritization scheme, decreasing significantly the examination waiting time of severe cases.

ObjectivesThis research aimed to study regulatory and operational aspects related to information security, especially confidentiality, in organizations that systematically carry out record linkage. ApproachWe searched international experiences of data linkage units from the literature and from the catalog of International Population Data Linkage Network (IPDLN) members. In addition, we surveyed technical standards of the International Association for Standardization (ISO) on health informatics. ResultsWe studied organizations in Australia, Canada, UK and the United States. Six standards were selected for deep analysis. In the end, we organized a set of 75 practices relating to information security in data linkage units, grouped by 5 dimensions: infrastructure and operations; record linkage model; relationship with managers; relationship with researchers and relationship with the society. The linkage process must be described in a sufficiently clear and didactic way, so that ordinary citizens are able to understand that the privacy of their health information is protected. In addition to a transparent work process, the data linkage center must also make their privacy policies available. The Australian and Canadian experiences with ethic review committees that include social participation and awareness of media and explanations to the public are a good source of inspiration. Regarding safety, the institutions responsible for health databases should apply security controls in their information systems to consider the rules on consent to perform record linkage.Ideally, all institutions should seek full compliance with the controls recommended in the technical safety standards. However, the scarcity of resources (human, financial and technical) lead to the prioritization of the implementation of these security controls. The criteria for this prioritization can be given by feasibility analysis (cost / time impact, benefits), providing an orderly road map for the adoption of these measures. ConclusionThe practices systematized in this study can be used in order to check current information security conditions of data linkage centers and as guidelines for further improvements. This will certainly bring more confidence in the data linkage center process and, at least, help researchers, managers and society move forward toward the same objective of better public health.