The Québec BCG Vaccination Registry (1956–1992): assessing data quality and linkage with administrative health databases

Abstract

BackgroundVaccination registries have undoubtedly proven useful for estimating vaccination coverage as well as examining vaccine safety and effectiveness. However, their use for population health research is often limited. The Bacillus Calmette-Guérin (BCG) Vaccination Registry for the Canadian province of Québec comprises some 4 million vaccination records (1926-1992). This registry represents a unique opportunity to study potential associations between BCG vaccination and various health outcomes. So far, such studies have been hampered by the absence of a computerized version of the registry. We determined the completeness and accuracy of the recently computerized BCG Vaccination Registry, as well as examined its linkability with demographic and administrative medical databases.MethodsTwo systematically selected verification samples, each representing ~0.1% of the registry, were used to ascertain accuracy and completeness of the electronic BCG Vaccination Registry. Agreement between the paper [listings (n = 4,987 records) and vaccination certificates (n = 4,709 records)] and electronic formats was determined along several nominal and BCG-related variables. Linkage feasibility with the Birth Registry (probabilistic approach) and provincial Healthcare Registration File (deterministic approach) was examined using nominal identifiers for a random sample of 3,500 individuals born from 1961 to 1974 and BCG vaccinated between 1970 and 1974.ResultsExact agreement was observed for 99.6% and 81.5% of records upon comparing, respectively, the paper listings and vaccination certificates to their corresponding computerized records. The proportion of successful linkage was 77% with the Birth Registry, 70% with the Healthcare Registration File, 57% with both, and varied by birth year.ConclusionsComputerization of this Registry yielded excellent results. The registry was complete and accurate, and linkage with administrative databases was highly feasible. This study represents the first step towards assembling large scale population-based epidemiological studies which will enable filling important knowledge gaps on the potential health effects of early life non-specific stimulation of the immune function, as resulting from BCG vaccination.

Shared decision‐making in outpatients with mental disorders: Patients´ preferences and associated factors

“…[34][35][36] Some authors who assessed preferences retrospectively found that most people preferred a passive role in decision-making, and when preferences were asked in general like in our study, the majority of patients more often preferred a passive role than when were asked about a more specific treatment option. 19 In general, our results are consistent with those of Cuevas, 4,15 who argued that SDM occurs very occasionally in Spanish National Health System despite of previous positive attitudes observed in our medical outpatient setting.…”

“…Our study adds to the existing research that showed that younger patients more often prefer to take a more active role in medical decisions. 19 Education level was also associated in our study with the preferences in the degree of participation in the decision-making process.…”

“…Our results are quite similar to those reported by other authors who found that those with fewer years of education may feel less confident about becoming involved in decisionmaking and more often desire a more passive role in medical decisions. 19,36 Our findings indicated that chronicity and severity of illness as measured by the number of admissions decreased the chance to prefer to be informed with all the illness details. As literature suggests, severity of illness may be linked with the desire of information, with the most serious ill patients showing less desire for information.…”

“…8,17,18 Moreover, not all people are prepared or want to participate in the same way in the decisions about their medical care. 19,20 Patients with severe psychiatric disorders, such as bipolar disorder or psychosis, may alternate periods of capacity and lack of capacity and therefore difficult in making autonomous decisions. 16 In standard psychiatric care, forms of coercion from subtle persuasion to compulsory admissions are still relatively common.…”

Electronic medical record integration with a database for adult congenital heart disease: Early experience and progress in automating multicenter data collection

“…The advancing goals of health information exchange on a wider scale will streamline this process [14]. This includes deterministic rather than probabilistic patient record matching [15,16], patient governance over their own health information [17], and simpler interoperability with other databases.…”