Justification of ethical considerations in health economics – Merging the theories of Niklas Luhmann and Charles Taylor

Dealing with ethics in health economics on socio-philosophical grounds is not yet well established. This paper shows how a liaison between the system theory of Luhmann and the philosophy of Taylor can be used to analyze and justify the incorporation of ethical considerations into health economics. One rationale for the incorporation of ethical consideration into health economics is the deficiencies in capturing all relevant needs of health system participants with common (welfare) economics. A second reason why health economics should account for ethical values is the fact that its decisions are already based on implicit value judgments. The impact of our approach is exemplified by the conc…

Evaluation of Record Linkage Methods for Iterative Insertions

Summary Objectives: There have been many developments and applications of mathematical methods in the context of record linkage as one area of interdisciplinary research efforts. However, comparative evaluations of record linkage methods are still underrepresented. In this paper improvements of the Fellegi-Sunter model are compared with other elaborated classification methods in order to direct further research endeavors to the most promising methodologies. Methods: The task of linking records can be viewed as a special form of object identification. We consider several non-stochastic methods and procedures for the record linkage task in addition to the Fellegi-Sunter model and perform an e…

Alcohol Consumption in HealthyOPRM1G Allele Carriers and Its Association with Impulsive Behavior

AIMS: A link between alcohol use disorders (AUD) and impulsivity is well established. As there is evidence for the heritability of AUD, the investigation of the underlying genetic disposition for both conditions is an important issue. An association between AUD and a coding single nucleotide polymorphism (SNP) (rs1799971 encoding an Asn40Asp amino acid substitution, A118G) within the µ-opioid receptor 1 gene (OPRM1) has been reported. Therefore we tested the association between the OPRM1 A118G polymorphism and drinking as well as impulsive behavior in social drinkers. METHODS: A total of 214 healthy male social drinkers were recruited. Each participant was genotyped for the OPRM1 A118G vari…

Bagging, bumping, multiview, and active learning for record linkage with empirical results on patient identity data

Record linkage or deduplication deals with the detection and deletion of duplicates in and across files. For this task, this paper introduces and evaluates two new machine-learning methods (bumping and multiview) together with bagging, a tree-based ensemble-approach. Whereas bumping represents a tree-based approach as well, multiview is based on the combination of different methods and the semi-supervised learning principle. After providing a theoretical background of the methods, initial empirical results on patient identity data are given. In the empirical evaluation, we calibrate the methods on three different kinds of training data. The results show that the smallest training data set, …

Deterministic Linkage as a Preceding Filter for Other Record Linkage Methods

Deterministic record linkage (RL) is frequently regarded as a rival to more sophisticated strategies like probabilistic RL. We investigate the effect of combining deterministic linkage with other linkage techniques. For this task, we use a simple deterministic linkage strategy as a preceding filter: a data pair is classified as ‘match' if all values of attributes considered agree exactly, otherwise as ‘nonmatch'. This strategy is separately combined with two probabilistic RL methods based on the Fellegi–Sunter model and with two classification tree methods (CART and Bagging). An empirical comparison was conducted on two real data sets. We used four different partitions into training data a…

Active learning strategies for the deduplication of electronic patient data using classification trees.

Graphical abstractDisplay Omitted Highlights? Active learning for medical record linkage is used on a large data set. ? We compare a simple active learning strategy with a more sophisticated variant. ? The active learning method of Sarawagi and Bhamidipaty (2002) 6] is extended. ? We deliver insights into the variations of the results due to random sampling in the active learning strategies. IntroductionSupervised record linkage methods often require a clerical review to gain informative training data. Active learning means to actively prompt the user to label data with special characteristics in order to minimise the review costs. We conducted an empirical evaluation to investigate whether…

Controlling false match rates in record linkage using extreme value theory

AbstractCleansing data from synonyms and homonyms is a relevant task in fields where high quality of data is crucial, for example in disease registries and medical research networks. Record linkage provides methods for minimizing synonym and homonym errors thereby improving data quality. We focus our attention to the case of homonym errors (in the following denoted as ‘false matches’), in which records belonging to different entities are wrongly classified as equal. Synonym errors (‘false non-matches’) occur when a single entity maps to multiple records in the linkage result. They are not considered in this study because in our application domain they are not as crucial as false matches. Fa…

Effect of nighttime aircraft noise exposure on endothelial function and stress hormone release in healthy adults.

Aims Aircraft noise disturbs sleep, and long-term exposure has been shown to be associated with increases in the prevalence of hypertension and an overall increased risk for myocardial infarction. The exact mechanisms responsible for these cardiovascular effects remain unclear. Methods and results We performed a blinded field study in 75 healthy volunteers (mean age 26 years), who were exposed at home, in random order, to one control pattern (no noise) and two different noise scenarios [30 or 60 aircraft noise events per night with an average maximum sound pressure level (SPL) of 60 dB(A)] for one night each. We performed polygraphy during each study night. Noise caused a worsening in sleep…

Open versus endoscopic bone resection of the dorsolateral calcaneal edge: a cadaveric analysis comparing three dimensional CT scans

The CpG island methylator phenotype in breast cancer is associated with the lobular subtype

Background: Aberrations in DNA methylation patterns are well-described in human malignancies. However, the existence of the ‘CpG island methylator phenotype’ (CIMP) in human breast cancer is still controversial. Materials & methods: Illumina's HumanMethylation 450K BeadChip was used to analyze genome-wide DNA methylation patterns. Chromosomal abnormalities were determined by array-based CGH. Results: Invasive lobular breast carcinomas exhibit the highest number of differentially methylated CpG sites and a strong inverse correlation of aberrant DNA hypermethylation and copy number alterations. Nine differentially methylated regions within seven genes discriminating the investigated subg…

Missing values in deduplication of electronic patient data

Data deduplication refers to the process in which records referring to the same real-world entities are detected in datasets such that duplicated records can be eliminated. The denotation ‘record linkage’ is used here for the same problem.1 A typical application is the deduplication of medical registry data.2 3 Medical registries are institutions that collect medical and personal data in a standardized and comprehensive way. The primary aims are the creation of a pool of patients eligible for clinical or epidemiological studies and the computation of certain indices such as the incidence in order to oversee the development of diseases. The latter task in particular requires a database in wh…

A practical framework for data management processes and their evaluation in population-based medical registries.

We present a framework for data management processes in population-based medical registries. Existing guidelines lack the concreteness we deem necessary for them to be of practical use, especially concerning the establishment of new registries. Therefore, we propose adjustments and concretisations with regard to data quality, data privacy, data security and registry purposes.First, we separately elaborate on the issues to be included into the framework and present proposals for their improvements. Thereafter, we provide a framework for medical registries based on quasi-standard-operation procedures.The main result is a concise and scientifically based framework that tries to be both broad a…