Oracle分区技术在公共卫生数据共享中的应用研究

目的提高公共卫生数据共享过程中海量历史数据的读写性能和可维护性。方法应用Oracle表分区技术和索引分区技术对公共卫生数据共享系统管理系统进行了优化。结果大大改善了系统性能,成倍提高了查询和统计的速度;提高了系统的可用性,数据备份与恢复工作更宜操作。结论采用有效合理的分区管理策略,能显著提高海量数据的读写性能和可维护性。  

Constructing whole of population cohorts for health and social research using the New Zealand Integrated Data Infrastructure

Objectives: To construct and compare a 2013 New Zealand population derived from Statistics New Zealand’s Integrated Data Infrastructure (IDI) with the 2013 census population and a 2013 Health Service Utilisation population, and to ascertain the differences in cardiovascular disease prevalence estimates derived from the three cohorts. Methods: We constructed three national populations through multiple linked administrative data sources in the IDI and compared the three cohorts by age, gender, ethnicity, area‐level deprivation and District Health Board. We also estimated cardiovascular disease prevalence based on hospitalisations using each of the populations as denominators. Results: The IDI population was the largest and most informative cohort. The percentage differences between the IDI and the other two populations were largest for males and for those aged 15–34 years. The percentage differences between the IDI and Census cohorts were largest for people living in the most deprived areas. The ethnic distribution varied across the three cohorts. Using the IDI population as a reference, the Health Service Utilisation population generally overestimated cardiovascular disease prevalence, while the Census population generally underestimated it. Conclusions and implications: The New Zealand IDI population is the most comprehensive and appropriate national cohort for use in health and social research.  

Addressing the challenges of cross‐jurisdictional data linkage between a national clinical quality registry and government‐held health data

Objective: To describe the challenges of obtaining state and nationally held data for linkage to a non‐government national clinical registry. Methods: We reviewed processes negotiated to achieve linkage between the Australian Stroke Clinical Registry (AuSCR), the National Death Index, and state held hospital data. Minutes from working group meetings, national workshop meetings, and documented communications with health department staff were reviewed and summarised. Results: Time from first application to receipt of data was more than two years for most state data‐sets. Several challenges were unique to linkages involving identifiable data from a non‐government clinical registry. Concerns about consent, the re‐identification of data, duality of data custodian roles and data ownership were raised. Requirements involved the development of data flow methods, separating roles and multiple governance and ethics approvals. Approval to link death data presented the fewest barriers. Conclusion: To our knowledge, this is the first time in Australia that person‐level data from a clinical quality registry has been linked to hospital and mortality data across multiple Australian jurisdictions. Implications for Public Health: The administrative load of obtaining linked data makes projects such as this burdensome but not impossible. An improved national centralised strategy for data linkage in Australia is urgently needed.  

A review of attitudes towards the reuse of health data among people in the European Union: The primacy of purpose and the common good

Health data are used for still more purposes, and policies are enacted to facilitate data reuse within the European Union. This literature synthesis explores attitudes among people living in the European Union towards the use of health data for purposes other than treatment. Our findings indicate that while a majority hold positive attitudes towards the use of health data for multiple purposes, the positive attitudes are typically conditional on the expectation that data will be used to further the common good. Concerns evolve around the commercialisation of data, data security and the use of data against the interests of the people providing the data. Studies of these issues are limited geographically as well as in scope. We therefore identify a need for cross-national exploration of attitudes among people living in the European Union to inform future policies in health data governance.  

Evaluation of organochlorine pesticides in breast milk samples in Turkey applying features of the partial order technique

Exposure data to organochlorine pesticides (OCPs) of mothers’ breast milk samples were measured in different locations in the Taurus Mountains/Turkey. Villages at five altitudes were looked upon. The data analysis method applied is the Hasse diagram technique, based on Discrete Mathematics. For each of the five regions, one Hasse diagram was calculated and showed the same maximal object, namely, p-p'-Dichlorodiphenyldichloroethane (DDE). In a further data investigation step, we performed the similarity analyses of the locations in order to quantify the similarities and incomparabilities. It was revealed that no correlation exists between most altitudes and the pattern of contamination of breast milk samples. The two lowest situated areas, Sahil at sea level and Ciftlikköy at 121 m above sea level were similar. We reduced the datasets by applying the interval analysis followed by similarity analyses. We observed that endrin (END1), mirex (MIRE), and pentachlorobenzene (PECB) reduce most severely the similarity.  

Meeting the information needs of the 'Health for all' challenge--lessons from Scotland

OBJECTIVE: To create a public health data resource for Scotland that is based on a socio-ecological model of the determinants of health and would, therefore, meets the needs of the emerging public health agenda. DESIGN: Action research, in which the approach moved logically through stages of action (conception, feasibility study, pilot projects, leading to a national set of integrated health and well-being profiles). Each stage built on the results of the previous research. RESULTS: The conceptual stage identified the need for an approach to public health data that kept pace with the increasingly accepted socio-ecological models of the determinants of health. A feasibility study concluded that sufficient data were available to populate the health fields that represented the important determinants of health. At this time strengths and weakness in data were defined. This led to the articulation of a 'vision' for integrated public heath data in Scotland that was the subject of a wide consultation. Pilot studies provided local stakeholders with imaginatively presented data (on population demographics, health and function, behaviour, social environment, economy, physical environment, morbidity and mortality) for their local communities. The response to these was so positive that a demand was created for a comprehensive set of 'community profiles'. These, in addition to parliamentary constituency profiles, have now been created and widely disseminated. CONCLUSIONS: It has been possible, despite many difficulties, to develop approaches to public health information that are informed by the socio-ecological model of health and create outputs that represent a significant advance on previous approaches to public health data. This is a work in progress and many issues remain unresolved. Interaction with others engaged in parallel tasks will facilitate the next steps.