Record Linkage Approaches Using Prescription Drug Monitoring Program and Mortality Data for Public Health Analyses and Epidemiologic Studies

Abstract

Background: The use of Prescription Drug Monitoring Program (PDMP) data has greatly increased in recent years as these data have accumulated as part of the response to the opioid epidemic in the United States. We evaluated the accuracy of record linkage approaches using the Controlled Substance Monitoring Database (Tennessee's [TN] PDMP, 2012-2016) and mortality data on all drug overdose decedents in Tennessee (2013-2016). Methods: We compared total, missed, and false positive (FP) matches (with manual verification of all FPs) across approaches that included a variety of data cleaning and matching methods (probabilistic/fuzzy vs. deterministic) for patient and death linkages, and prescription history. We evaluated the influence of linkage approaches on key prescription measures used in public health analyses. We evaluated characteristics (e.g., age, education, sex) of missed matches and incorrect matches to consider potential bias. Results: The most accurate probabilistic/fuzzy matching approach identified 4,714 overdose deaths (vs. the deterministic approach, n = 4,572), with a low FP linkage error (<1%) and high correct match proportion (95% vs. 92% and ~90% for probabilistic approaches not using comprehensive data cleaning). Estimation of all prescription measures improved (vs. deterministic approach). For example, frequency (%) of decedents filling an oxycodone prescription in the last 60 days (n = 1,371 [32%] vs. n = 1,443 [33%]). Missed overdose decedents were more likely to be younger, male, nonwhite, and of higher education. Conclusion: Implications of study findings include underreporting, prescribing and outcome misclassification, and reduced generalizability to population risk groups, information of importance to epidemiologists and researchers using PDMP data.

Data integration of National Dose Registry and survey data using multivariate imputation by chained equations

“…Data integration including statistical matching, and record linkage is the process of merging information from several heterogeneous datasets [ 8 – 12 ]. Data integration and analysis using linked data have been steadily studied in epidemiology [ 13 – 15 ]. Data integration has the advantage of enabling users or researchers to implement statistical analysis for variables that cannot be jointly observed within each dataset.…”

Virtual patient identifier (vPID): Improving patient traceability using anonymized identifiers in Japanese healthcare insurance claims database

“…Researchers actively studied how to merge patient records in healthcare databases [ [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] ]. These studies can be roughly grouped into three approaches: a deterministic approach [ [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ], a probabilistic approach [ [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] ], and a hybrid approach [ [59] , [60] , [61] , [62] , [63] ]. Our method can be categorized into the deterministic approach, but it can be extended by incorporatin...…”

Ensemble learning to predict opioid-related overdose using statewide prescription drug monitoring program and hospital discharge data in the state of Tennessee

“…Patient linkage across our datasets relied on TDH-determined master patient indexing. 39 Only records with valid person identifiers were retained, and records determined to be related to a nonhuman patient (ie, veterinary prescription records) were removed. Hospital records from the HDDS were limited to verified inpatient encounters.…”