bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Data Linkage Method to Compile Life Tables for Aboriginal and Torres Strait Islander Australians
Authors: Shahidullah Mohammed 
Published: December 2020

IntroductionAlmost all deaths of Aboriginal and Torres Strait Islander Australians are registered, but some are not identified and recorded as such when registered. Therefore, registration data underestimates the actual number of deaths and death rates of Aboriginal and Torres Strait Islander Australians, and consequently their application can result in overestimates of life expectancy.
Hence registered deaths needs to be adjusted before deriving life tables and life expectancy estimates.
Objectives and ApproachObjective: To develop a data-driven method for estimating factors for adjusting registered deaths.
Approach: The Australian Bureau of Statistics (ABS) linked Census records to all deaths that were registered within a year following the Census. Adjustment factors were estimated by directly comparing Indigenous status of a person reported in Census and death registration data. The ABS then used an established and widely used method to compile life tables, by making up-front adjustments to registered deaths by the factors derived from the Census and deaths linked dataset.
ResultsAboriginal and Torres Strait Islander deaths identification rate in registration data was estimated to be 89% at the national level in 2016-2017. Over the same period, identification rates varied considerably by state/territory and ranged between 0.69%-1.04%. It clearly showed the need to adjust for under/over identification in Aboriginal and Torres Strait Islander death registrations.
Conclusion / ImplicationsStatistical data linkage methods can successfully be used to improve Aboriginal and Torres Strait Islander Australians life expectancy estimates. This has implications for accurately measuring and monitoring the Council of Australian Governments’ ‘Closing the Gap’ target in life expectancy estimates between Aboriginal and Torres Strait Islander and non-Indigenous populations.
Introducing Health Data Research Network Canada (HDRN Canada): A New Organization to Advance Canadian And International Population Data Science
Authors: McGrail Kimberlyn , Diverty Brent , Lix Lisa 
Published: December 2020

IntroductionNotwithstanding Canada’s exceptional longitudinal health data and research centres with extensive experience transforming data into knowledge, many Canadian studies based on linked administrative data have focused on a single province or territory. Health Data Research Network Canada (HDRN Canada), a new not-for-profit corporation, will bring together major national, provincial and territorial health data stewards from across Canada. HDRN Canada’s first initiative is the $81 million SPOR Canadian Data Platform funded under the Canadian Institutes of Health Research Strategy for Patient-Oriented Research (SPOR).
Objectives and ApproachHDRN Canada is a distributed network through which individual data-holding centres work together to (i) create a single portal and support system for researchers requesting multi-jurisdictional data, (ii) harmonize and validate case definitions and key analytic variables across jurisdictions, (iii) expand the sources and types of data linkages, (iv) develop technological infrastructure to improve data access and collection, (v) create supports for advanced analytics and (vi) establish strong partnerships with patients, the public and with Indigenous communities. We will share our experiences and gather international feedback on our network and its goals from symposium participants.
ResultsIn January 2020, HDRN Canada launched its Data Access Support Hub (DASH) which includes an inventory listing over 380 datasets, information about more than 120 algorithms and a repository of requirements and processes for accessing data. HDRN Canada is receiving requests for multi-province research studies that would be challenging to conduct without HDRN Canada.
Conclusion / ImplicationsThus far, HDRN Canada services and tools have been developed primarily for Canadian researchers but HDRN Canada can also serve as a prompt for an international discussion about what has/has not worked in terms of multi-jurisdictional research data infrastructure. It can also present an opportunity for the development of metadata, standards and common approaches that support more multi-country research.
Case Study for Stroke: National Stroke Data Linkage Program
Authors: Kilkenny Monique F , Kim Joosup , Dalli Lachlan , Eliakundu Amminadab , Olaiya Muideen 
Published: December 2020

IntroductionStroke is a leading cause of death and disability. Since 2012, our innovative national data linkage program, has enabled the successful linkage of data from the Australian Stroke Clinical Registry (AuSCR) with national and state-based datasets to investigate the continuum of stroke care and associated outcomes.
Objectives and ApproachUsing stroke as a case study, in this symposium we will describe the use of linked data to undertake clinical and economic evaluations and contribute new knowledge for policy and practice. We have undertaken a range of iterative and innovative projects linking the AuSCR (used now in >80 public hospitals across Australia with follow-up survey of patients between 90-180 days) with various administrative datasets. Linkages with the National Death Index, inpatient admissions and emergency presentations, Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), Aged Care services; Ambulance Victoria, Australian Rehabilitation Outcomes Centre and general practice network datasets (POLAR) have been achieved.
ResultsThe symposium will provide case studies and results from four data linkage projects involving the AuSCR: 1) Stroke123 (NHMRC: #1034415), a study to investigate the impact of quality of acute care on admission/emergency presentations and survival; 2) PRECISE (NHMRC:#1141848), a study to evaluate models of primary care involving linkages with PBS/MBS, aged care services and admissions/emergency data; 3) AMBULANCE: a study to investigate how pre-hospital care affects acute stroke care involving linkages with the ambulance and admissions/emergency datasets; and 4) POLAR: a study to understand the long-term management of stroke involving linkages with primary health data.
Conclusion / ImplicationsThe National Stroke Data Linkage Program has been visionary and remains highly contemporary in the field of linked data. A unique feature of this program is the active participation of clinicians and policy-makers to ensure the evidence generated have direct benefits for accelerating change in practice and informing policy.
Association Between Optimal Combination Pharmacotherapy and Survival After Stroke: A Registry and Pharmaceutical Dispensing Study
Authors: Kilkenny Monique F , Dalli Lachlan L , Kim Joosup , Andrew Nadine E , Sanfilippo Frank M , Sundararajan Vijaya , Dewey Helen M , Grimley Rohan , Thrift Amanda G , Cadilhac Dominique A 
Published: December 2020

IntroductionTo prevent further vascular events, prescribing of multiple classes of medications (antihypertensive, antithrombotic and lipid-lowering) is recommended in national clinical guidelines following ischaemic stroke.
Objectives and ApproachUsing real-world data, we determined the association between optimal combination pharmacotherapy (supply of all three classes, “optimal pharmacotherapy”) and survival after stroke. We linked a cohort of patients with first-ever ischaemic stroke from the Australian Stroke Clinical Registry (2010-2014) with national pharmaceutical dispensing and national mortality data. Cox regression was used to determine associations between pharmacotherapy in the first 30 days of stroke with 1-year (from day 31 to 395) all-cause mortality. All analyses were adjusted for socio-demographic (age, sex) and clinical characteristics (stroke severity, discharge destination).
ResultsAmong 6684 patients discharged following first-ever ischaemic stroke (median length-of-stay 5 days), 6466 patients who survived to 30 days were included (44% female, median age 74 years). During the first 30 days from discharge, 71.4% received ≥1 medication class, and 32.9% (n=2125) received optimal pharmacotherapy. Patients with optimal pharmacotherapy were older (≥75 years 50.3% vs <75 years 44.5%; p<0.001), discharged directly home (home 58.5% vs other 40.3%; p<0.001) and experienced a less severe stroke (able to walk on admission 46.9% vs 36.4%; p<0.001), than those without optimal pharmacotherapy. Between day 31 and 395, there were 667 deaths; 530 related to cardiovascular disease. Compared to no medication, treatment with two medications was associated with a 42% lower risk of death (hazard ratio [HR]: 0.58; 95%CI: 0.45-0.73); and optimal pharmacotherapy had a 62% lower risk of death (HR: 0.38; 95% CI: 0.31-0.47). Survival was similar between those with one or no medication.
Conclusion / ImplicationsPatients with ischaemic stroke who received optimal pharmacotherapy within 30-days of admission had greater one-year-survival. Further research is required to understand reasons for sub-optimal pharmacotherapy in these patients.
The Impact of Family and Domestic Violence on Children’s Early Developmental Outcomes
Authors: Orr Carol , Fisher Colleen , Glauert Rebecca , Preen David , O’Donnell Melissa 
Published: December 2020

IntroductionChildren have a universal right to live free from exposure to family and domestic violence (FDV). Young children (<6-years) are at greater risk of exposure to FDV due to the time spent in the family home and parental dependence. Despite the limited empirical literature, it is acknowledged that FDV exposure can impact a child’s developmental outcomes with respect to social competence including social, emotional, and cognitive skills.
Objectives and approachOur cohort study used longitudinal population-level data from Western Australia Police and hospital data to identify FDV, these datasets were genealogically linked to the children and their Australian Early Development Census (AEDC) to investigate the early development outcomes of Western Australian children born 2002-2010 (N=6,955).
Our aim was to determine if children exposed to FDV had greater vulnerability in early development outcomes as measured by the Australian Version of the Early Development Instrument (used in the AEDC), in the child’s first year of formal schooling (2009-2015).
Multivariate logistic regression was used to estimate the odds of children exposed to FDV being classed as developmentally vulnerable in each of the five AEDC development domains: physical health and wellbeing; social competence; emotional maturity; language and cognitive skills (school-based) and; communication skills and general knowledge. Models were adjusted for a range of covariates known to impact developmental outcomes.
ResultsChildren exposed to FDV had between 42% and 69% higher odds than non-exposed children of being developmentally vulnerable in the five domains. Additionally, children exposed to FDV had significantly higher odds of being developmentally vulnerable in two or more domains compared to children who were not exposed (adjustedOR 1.70; 95%CI 1.46-1.97).
ConclusionsExposure to FDV increases the odds of vulnerability in early development outcomes. Early intervention for children exposed to FDV to mitigate the impact on outcomes, and ultimately the need to prevent FDV is clearly needed.
Higher Education Completion Rates for Domestic Undergraduate Students Who Access Mental Health Services Using A Multi-Agency Matched Population Cohort
Authors: Cowie Lewis , Hendrickson Luke 
Published: December 2020

By linking Education, Health, and Welfare data in the Multi-Agency Data Integration Project (MADIP), our analysis looked at the impact of poor mental health on the likelihood of completing an undergraduate degree in Australia.
IntroductionCompletion of a bachelor degree is important to both the student and the government, as it provides lifelong benefits and prevents investment loss. Previous research has reported conflicting findings regarding whether students with mental ill health are less likely to complete a degree, with an estimated 25 per cent of young adult university students experiencing mental ill-health each year.
Objectives and ApproachOur research analysed national mental health service use and related pharmaceutical prescriptions linked with education data to determine the extent and effect of known mental health conditions on undergraduate student six-year completion rates. We followed a de-identified cohort of 120,000 students who commenced an undergraduate degree for the first time in 2011 for six years. Summary statistics and a binomial logit was used on a matched sample to confirm significance.
ResultsWe found that students with a known mental health condition had a significantly lower six-year completion rate (58 per cent) than those students with no known mental health condition (71 per cent). By simulating a randomised control trial controlling for a wide range of demographics, we showed that these results held and that completion rates worsened with increasing severity of mental health conditions, as measured by usage of psychiatric services.
ConclusionIntegrated data assets such as MADIP help us better understand the interaction between student success and mental health conditions which in turn will help us improve policy and better evaluate programs.
Association Between Use of Statins and Survival After Stroke: Real-World Data from The Australian Stroke Clinical Registry
Authors: Dalli Lachlan L , Kim Joosup , Cadilhac Dominique A , Andrew Nadine E , Sanfilippo Frank M , Thrift Amanda G , Sundararajan Vijaya , Kilkenny Monique F 
Published: December 2020

IntroductionDespite being recommended in clinical guidelines for secondary prevention of stroke, there are limited real-world data on outcomes associated with use of statins post-stroke.
Objectives and ApproachWe aimed to investigate the association between statin use and cardiovascular mortality post-stroke. We conducted a retrospective cohort study using prospectively collected data from the Australian Stroke Clinical Registry (2010-2014), linked with national medication dispensing and mortality data. We observed adult patients with first-ever ischaemic stroke or transient ischaemic attack (TIA) for 1-year following hospital discharge, or until their date of death, whichever occurred first. Statin use, defined as having an available statin dispensing, was assessed daily and treated as a time-varying exposure to account for patients who discontinued or reinitiated statins during follow-up. Multivariable, competing-risks regression, with non-cardiovascular death as the competing risk, was used to investigate the association between statin use and 1-year cardiovascular mortality.
ResultsAmong 8363 patients discharged following first-ever ischaemic stroke or TIA (48% aged ≥75 years, 45% female, 20% TIA, median length-of-stay 5 days), 945 died within 1 year, with 763 deaths being cardiovascular-related. The proportion of statin users was 65% at 90 days, 64% at 180 days, and 62% at 1 year. Groups least likely to be statin users at 1-year were women (odds ratio [OR]: 0.75; 95% CI: 0.67-0.85), patients aged <65 years (OR: 0.80; 95% CI: 0.69-0.92), and those discharged directly home (OR: 0.77; 95% CI: 0.67-0.88). Compared to non-use, use of statins was associated with a reduced risk of cardiovascular mortality within 1 year overall (sub-distribution hazard ratio [SHR]: 0.40; 95% CI: 0.34-0.46), and in sub-groups of patients with TIA, severe stroke, and advanced age.
Conclusion / Implications:Our preliminary data provide evidence of survival benefits associated with post-stroke statin use. Interventions to improve medication adherence may assist in reducing post-stroke mortality.
Using Linked Administrative Health and Family Court Data to Evaluate Maternal Mental Health-Related Risk Factors for Repeated Child Removals
Authors: Pearson Rachel J , Bedston Stuart , Wijlaars Linda , Gilbert Ruth 
Published: December 2020

IntroductionEvidence suggests that many women whose children enter care via family court proceedings (care proceedings) in England experience mental health and substance misuse problems. Further, an estimated 22% of women will return to court within 5 years for subsequent proceedings, often returning quickly with a new infant and with little time to address underlying health-related problems. With growing pressures on England’s family justice system and the wider children’s social care sector, there is a need to identify opportunities to engage with women in a healthcare setting to reduce the likelihood of (recurrent) care proceedings.
Objectives and ApproachWe used linked family court and mental health service data (n = 2843) for mothers who were referred to mental health services and were involved in care proceedings in South London between 2007 and 2019. We (1) describe differences in the frequency, type and timing of mental health and addictions service use between mothers who return to court and those who do not and (2) evaluate risk/protective factors for returning to court.
ResultsAfter resolving duplicate matches (n = 2808), 1028 women (36.6%) referred to mental health services over the study period subsequently returned to court. We will describe differences in characteristics of service use and care proceedings between women who return to court and those that do not. We will also explore a range of potential risk/protective factors for returning to court, including maternal age at first child, indicators for failure to engage with services, mental disorder type, substance misuse, and maternal neighbourhood deprivation status.
Conclusion / ImplicationsBetter understanding of how women use mental health and addictions services before, during and after proceedings, and identification of key risk/protective factors for returning to court, would inform strategies to reduce recurrent involvement in care proceedings among this population group.
Factors Associated with Unplanned Admission to Hospital: A National Time-To-Event Analysis of Over 65s In Scotland
Authors: Henderson David , Atherton Iain , McCowan Colin , Mercer Stewart , Bailey Nick 
Published: December 2020

IntroductionMany high-income countries are reorganising and integrating health and social care (long-term care) services. However, little evidence exists showing how these services interact. Demographic changes and austerity measures have led to increased demand for social care services at the same time as the availability of formal and informal services has declined. The aim of this study was to identify risks for unplanned hospital admission taking account of social care receipt, multimorbidity and sociodemographic status.
Objectives and ApproachThis retrospective, observational study included all individuals over the age of 65 in Scotland in financial year (Apr-March) 2015/16 (n = 879,027). The main outcome was time to first unplanned hospital admission. Kaplan-Meier curves were plotted to compare survival rates. Cox proportional hazards regression models were used to determine risk factors for unplanned admission. Explanatory variables included: receipt of social care, multimorbidity, socioeconomicposition, age, and sex.
ResultsMultivariate analysis showed that, after adjusting for: age, sex, multimorbidity, socioeconomic position, and any past unplanned admissions, receipt of social care was associated with a two-fold increased risk of having an unplanned admission compared to those without care (HR 1.98 95%CI 1.95-2.00). Increasing age, severity of multimorbidity, and lower socioeconomic position were also all associated with increasing risks of unplanned admission.
Conclusion / ImplicationsOur results show those in current receipt of social care are also more likely to use unplanned hospital care compared with those that do not receive care. Current provision of social care services is unlikely to lead to reductions in unplanned hospital admission.
Using Integrated Administrative Data to Support A Field Enumeration Census: The Case of The New Zealand 2018 Census
Authors: Bycroft Christine , Morgan Abby , Matheson-Dunning Nathaniel 
Published: December 2020

IntroductionThe New Zealand 2018 Census faced major challenges when implementing a new collection model, leading to a lower than expected response rate. The scale of the non-response meant planned methods for unit imputation were unlikely to be suitable, and new methods were developed to use administrative sources to count those who had been missed by the census field collection.
Objectives and ApproachThis innovative approach was made possible because of the extensive linked administrative data available in Stats NZ’s Integrated Data Infrastructure, the IDI,and built on previous research that had developed an administrative New Zealand resident population. New statistical methods were developed to account for known limitations of the administrative sources.
ResultsAdministrative records were successfully incorporated into the census dataset producing New Zealand’s first ‘combined census’. Assessment against benchmark population distributions and sensitivity analysis indicate that the results are close to what is expected. Stats NZ is confident it has compiled acensus dataset that will provide census usually resident population counts and electoral counts of acceptable quality.
Legal, security and privacy issues have been carefully assessed and managed, although there remain outstanding questions about ‘social license’.
Conclusion / ImplicationsAdministrative data does include many people who are typically hard to count through census field collection, and makes a significant quality improvement over previous census methods for non-response adjustment. A similar approach will be used to mitigate for non-response in the next census.
The lower than expected response rates and new data and methods have brought increased scrutiny of the census results. A different error structure from previous censuses (including improved counts of formerly under-counted ethnic groups) has disrupted time series for many variables.
Estimating Maternal Mortality Rates During The 1918 Flu Using Birth to Death Linkage
Authors: Christen Peter , Garrett Eilidh , Nowok Beata , Reid Alice , Williamson Lee , Dibben Chris 
Published: December 2020

IntroductionThe Digitising Scotland project (https://digitisingscotland.ac.uk/) has transcribed all Scottish birth, death, and marriage certificates from 1855 to 1974. The linkage of these data will provide formidable challenges for linkage experts and a multitude of opportunities for health and social science researchers.
Objectives and approachWe linked birth between November 1916 and December 1923 to death of women aged 15 to 49 who died between January 1917 and December 1923. We only linked a death up-to 42 days after a birth. We compared parent names with those of the deceased and her spouse, as well as their address, using string matching functions. Given the lack of ground truth data, we conducted a sensitivity analysis using different similarity thresholds to classify birth linked to death as matches (if their similarity was at least a given threshold), or otherwise as non-matches. We then calculated the maternal mortality rate (MMR) on a monthly basis for January 2017 to July 2018 (the pre-flu period), and October 1918 to March 1919 (the flu period) as the number of matched birth to death certificates divided by the average monthly number of birth in the month of death and the previous month.
ResultsPuerperal risk of death during this period was much higher than for the comparable female age group during the different phases of the 1918 flu. During the October 1918 wave, puerperal women were at greater risk than women of the same age, while the risk dropped below the expected in the summer of 1919. We carried out a sensitivity analysis by linking with different similarity thresholds and found our findings were robust to these decisions.
ConclusionsWe have shown how a large and complex data collection can be successfully linked, resulting in new opportunities for various studies in the health and socialsciences.