bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of the COVID-19 Pandemic on End-of-Life Prescribing in Ontario Nursing Homes.
Authors: Milani Christina , Webber Colleen , Clarke Anna , Isenberg Sarina , Downar James , Kobewka Daniel , Hsu Amy , Lau Jenny , Sinnarajah Aynharan , Simon Jessica , Boese Kaitlyn , Arya Amit , Roberts Rhiannon , Turcotte Luke , Howard Michelle , Maxwell Colleen , Robert Benoit , Tanuseputro Peter 
Published: August 2022

ObjectivesOur preliminary work revealed significant variations in the prescribing of end-of-life symptom management medications in nursing homes prior to the onset of the COVID-19 pandemic. In this study, we sought to explore whether the prescribing of end-of-life medications in nursing homes changed with the onset of the pandemic.
ApproachThis was a retrospective cohort study of nursing home residents age 65+ who died in Ontario, Canada, divided into two time periods based on death date: pre-COVID-19 (January 1st, 2017 – March 17th, 2020) and during COVID-19 (March 18th, 2020 – March 31st, 2021). Using routinely collected health administrative data and our evidence-based end-of-life medications list, we linked resident data to prescription claims to identify whether residents were prescribed these medications in the last 14 days of life. We grouped homes into quintiles according to the proportion of decedents who received ≥1 prescription and examined changes in prescribing before and during COVID-19.
ResultsNursing homes in the lowest prescribing quintile prescribed, on average, 11.5% fewer end-of-life symptom management medications during COVID-19 compared to pre-pandemic. Conversely, homes in the highest quintile prescribed an average of 13.7% more medications during COVID-19. Nursing homes in the lowest quintile had more COVID-19-positive residents (33% of residents) compared to homes in the highest quintile (9% of residents). Additionally, nursing homes in the lowest prescribing quintile spent more time with active COVID-19 outbreaks compared to homes in the highest quintile (mean 72.7 days versus 24.1 days, respectively, standardized difference 0.819).
ConclusionThe COVID-19 pandemic has disproportionately impacted nursing homes across Canada. Our findings suggest that nursing homes with low rates of prescribing of end-of-life medications prior to the pandemic had even lower prescribing rates during the pandemic. These homes were also harder hit by COVID-19 infections and outbreaks.
Multi-sectoral data linkages to explore associations between the built environment and BMI.
Authors: Fry Richard , Griffiths Lucy , Daniels Helen , Mizen Amy , Johnson Rhodri , Bailey Rowena , Rafferty James , Pedrick-Case Rebecca , Stratton Gareth , Pouliou Dora 
Published: August 2022

ObjectivesIn Wales almost a quarter of adults and 1 in 8 reception age children are obese. Linked data is a key tool to understanding the role of the built environment on obesity rates and is an important part of developing strategies to combat the obesity epidemic in Wales.
ApproachWe set out to develop an analytical platform for generating evidence on key aspects of the built environment which impact child and adult obesity including; walkability, fast food availability, green space size and qualities, active transport routes and school environments. Utilising the Secure Anonymised Information Linkage (SAIL) Databank We linked multi-sectoral data including routine health data, cohort data, administrative data and linked Geographic Information Systems generated metrics at household and school level. The platform will inform policy makers with and facilitate a better understanding of associations between a range of social, health and built environment factors.
ResultsWe have created a range of built environment variables including temporally and age varying walkability indices, viewable greenspace, garden and house size, access to services and parks for 1.5 million households. In the first instance, as part of the BEACHES project, this data has been linked to several health datasets including the Child Measurement Programme (CMP, n=188,800) where initial results have shown that associations between garden size and Body Mass Index in children displays a non-linear negative correlation. We have also created follow-up measures for the CMP using routinely collected general practice data which further enables linking 28,389 height and weight measurements. However, potential bias in these follow-up measures is poorly understood with further work being undertaken to assess usability.
ConclusionThe integrated multi-sectoral data platform approach to linking environmental, administrative, health and cohort data aims to develop insights on a range of public health issues. We are working with a range of stakeholders to develop evidence-based policy initiatives to reduce obesity in Wales.
Hwb learning platform: data insights into learning and teaching continuity throughout the COVID-19 pandemic.
Authors: Sandu Alexandra 
Published: August 2022

The COVID-19 pandemic has prompted everyone to adapt and find a solution to face-to-face contact, including the educational community, which had to suspend face-to-face teaching in order to prevent the spread of the new virus. Wales, confronted with the need to close schools to avoid the spread of the virus, did so in March 2020, shifting the majority of its delivery online. Indeed, Wales’ Hwb Digital Learning Platform was perfectly poised as a resource to address this unique challenge. Furthermore, because it provides monthly usage statistics across the system, it was a valuable resource for monitoring the transition to online digital teaching and learning and, more importantly, identifying any variations or inequalities in usage. Linking administrative datasets containing information about the schools and Hwb usage (logins) for the academic year 2019/2020, this research aims to explore the continuity of learning and teaching in Wales using statistical methods, by highlighting patterns and changes in the Hwb Learning Platform usage during the lockdown in Wales, with an emphasis on the first school closure owning to the COVID-19 pandemic, as well as the digital learning inequalities that have emerged during the same timeframe. The findings show that during the lockdown, pupils and staff are more engaged with Hwb, with a peak in April 2020, however, engagement varies significantly not only across school sectors but also between Consortia and within them.
Variation in access rates amongst patients groups in Wales for specialist interventions.
Authors: Davies Gareth , Smith Kendal , Akbari Ashley , Bailey Rowena , Evans Lloyd , John Gareth , Thomas Michael , Lutchman-Singh Kerryn 
Published: August 2022

ObjectivesThe Welsh Health Specialised Services Committee (WHSSC) has commissioned a study to assess if there is a standard value-based approach to measure and evaluate the effectiveness of specific interventions, and whether variation exists that may indicate differences in the equity of access to these services provided to patients in Wales.
ApproachUsing anonymised individual-level, population-scale, routinely collected electronic health record (EHR) data held within the Secure Anonymised Information Linkage (SAIL) Databank, we planned to identify amongst the population of Wales any patients experiencing percutaneous coronary intervention (PCI) and Transcatheter Aortic Valve Implantation (TAVI). We would measure associated patient outcomes 2-years before and after the intervention minus a 6-month clearance period on either side by measuring primary care attendances in general practice, and secondary care attendances in hospital, outpatient and emergency department data. To further inform the analysis, linkage to socio-demographic factors, comorbidities and lifestyle factors would be controlled for.
ResultsPreliminary results identified 5,999 PCIs between June 2014 and March 2020. We were able to identify 1,530 as elective and 4,358 as emergency secondary care procedures. Of the elective PCIs, 184 patients had a greater number of elective hospital days pre-PCI, and 382 patients had a greater number of elective hospital days post-PCI. Of the emergency PCIs, 135 patients had a greater number of emergency hospital days pre-PCI, and 893 patients had a greater number of emergency hospital days post-PCI. For TAVI intervention, we identified 74 elective and 49 emergency procedures. 35 of the elective TAVI had greater hospital days pre-intervention, and 17 of the elective TAVI had greater hospital days post-intervention. Primary care costs slightly rose for PCI and slightly reduced for TAVI.
ConclusionWe successfully identified interventions and measured and contrasted outcomes before and after the intervention using the SAIL Databank. For PCI, the elective intervention showed a reduced increase in bed days compared to emergency intervention. These initial findings allow us to plan an expanded analysis to examine other intervention types.
Associations between neighbourhood fast-food environments and hypertension in Canadian adults.
Authors: Stevenson Andrew C. , Colley Rachel C. , Dasgupta Kaberi , Minaker Leia M. , Riva Mylene , Widener Michael J. , Ross Nancy A. 
Published: August 2022

ObjectivesHypertension is a leading cause of cardiovascular disease and premature death. Neighbourhoods characterized by a high proportion of fast-food outlets may contribute to hypertension in residents; however, limited research has explored these associations. The objectives of this study were to assess associations between neighbourhood fast-food environments, measured and self-reported hypertension.
ApproachWe used data from 10,700 adults who participated in six cycles of the Canadian Health Measures Survey (CHMS). Measured hypertension was defined as having an average systolic blood pressure (BP) of ≥140, a diastolic BP ≥90 mm Hg or being on BP lowering medication. Participants were also asked if they had been diagnosed with high BP or if they take BP lowering medication (i.e., self-reported hypertension). We characterized the fast-food environment of each participant’s neighbourhood using the Canadian Food Environment Dataset (Can-FED). We considered the proportion of fast-food outlets relative to fast-food outlets and full-service restaurants as a continuous variable.
ResultsThe mean proportion of fast-food outlets was 23.3% (SD 26.8%). A one standard deviation (SD) increase in the proportion to fast-food outlets was associated with higher odds of measured hypertension in the full sample (OR=1.17, 95% CI 1.05 to 1.31) and in sex-specific models (women: OR=1.14, 95% CI 1.01 to 1.29; and men: OR=1.21, 95% CI 1.03 to 1.43). A one standard deviation (SD) increase in the proportion to fast-food outlets was associated with higher odds of self-reported hypertension in the full sample (OR=1.13, 95% CI 1.02 to 1.24); however, associations were inconclusive in sex-specific models (women: OR=1.11, 95% CI 0.99 to 1.26; and men: OR=1.14, 95% CI 0.99 to 1.33).
ConclusionBy linking neighbourhood food environment measures that were created from an administrative data source (the Statistics Canada Business Register) to individual-level data from the CHMS, we were able to demonstrate that reducing the proportion of fast-food outlets in neighbourhoods may reduce rates of hypertension and support individually targeted interventions.
Privacy Preserving Technologies in US Education.
Authors: O'Hara Amy , Straus Stephanie 
Published: August 2022

In the US education sector, data are captured on learners at all stages of the life course with rich, sensitive information on learner demographics, enrollment, achievement, borrowing, and outcomes. Most data are controlled by institutions, who increasingly want to monitor progress from cradle to career, tracking students from early childhood through primary and secondary schools (K-12), on to degrees granted in postsecondary institutions, including continuing and technical education that grant credentials. Collecting, storing, and using such data raises privacy concerns.
This presentation describes privacy preserving technologies (PPTs) that have been discussed, tested, implemented – and abandoned – in the education domain. These include both input and output privacy protection methods ranging from absolute lockdowns of learner data to cryptographically-protected data access and analysis systems. We describe most familiar and tested PPTs including secure hashing, secure multiparty computation, trusted execution environments, and differential privacy, highlighting actual applications in schools, departments of education, and educational technology nonprofits and companies.
We summarize the factors that limit PPT use and success, including legal, institutional, technical, and cultural barriers and offer recommendations to overcome these barriers. For example, we find gaps in understanding what PPTs are and what problems they solve; a lack of engagement with data controllers, subjects, and regulators; and a lack of human capital to implement and use PPTs. There are also significant research and development needs to continue making PPTs less costly in financial, compute, and complexity terms. Our recommendations suggest topics for continued research into methods that produce disaggregate statistics to analyze equity while protecting privacy, have clear and fair privacy loss budgets, and produce open-source technology, ideally pairing scientists with education experts.
The benefits and challenges of applied, partnered data-intensive research.
Authors: Mcgrail Kim , Clement Fiona , Law Michael 
Published: August 2022

ObjectivePopulation data scientists are committed to research that has public value. Much of this research is applied; it is undertaken in partnership with the public, patients, families, as well as policy- and decision-makers. Working directly with policy-makers (who are often also data providers) has advantages, but presents challenges as well.
ApproachWe offer four provocations to stimulate thinking about the relationship between research and the “systems” that research is trying to influence. These provocations include: 1) assessing the implications of “partnership” and who is expected to change or accommodate others’ views, and how this affects researchers’ ability to challenge current practice; 2) challenging the emphasis on short-term over longer-term challenges in systems; 3) moving beyond post-implementation evaluations of policies; and 4) critiquing the current project-specific orientation to assessing return on investment (ROI).
ResultsThe current focus on partnership in applied research tends to suggest that it is researchers who need to be empathetic to the timelines and needs of policy makers. True relationships, however, are bi-directional, and more importantly need to be open to tough conversations and constructive feedback. Further, focusing on priorities of “systems” will emphasize short-term issues. These are important to address, but can crowd out more systemic and structural considerations. This leads to researchers often engaged in post-implementation evaluation where they have had little involvement in policy or intervention design, which may not be evidence-based. Finally, a focus on single-project ROI will tend to undervalue riskier – but also potentially more rewarding – research.
ConclusionIt is important to recognize that valuable research might challenge current thinking and practice, and/or address issues that are not short-term priorities. More early testing of policies before broad implementation will advance evidence. ROI should be viewed as an emergent property rather than an attribute of each individual project.
Using linked administrative data to build a Social Disparities Index for Covid-19 to evaluate the effects of inequalities on pandemic in Brazil.
Authors: Ichihara Maria Yury Travassos , Fiaccone Rosemeire Leovigildo , Da Costa Lilia Carolina Carneiro , De Medeiros Aline Grimberg Pereira , Pinto Junior Elzo Pereira , Da Silva Souza Rafael Felipe , Barreto Mauricio Lima , Ara Anderson , Goes Emmanuelle , Pescarini Julia M , Barreto Marcos Ennes , Gregorio Jaime 
Published: August 2022

ObjectiveBrazil is one of the most unequal countries in the world. We aimed to create a Social Disparities Index for Covid-19 (SDI-Covid-19) using linked administrative data to understand the role of inequalities in the COVID-19 pandemic to target social and health policies.
ApproachUsing linked administrative data (2010 Census and National Registry of Health Establishments) we selected municipal indicators for three domains: a) Brazilian Deprivation Index; b) % black/brown/indigenous, % people living in housing with density >2 person/room, % poor older people as sociodemographic; c) ICU beds and respirators rates weighted by distance to the health region headquarters as access to health service. A z-score weighted by the population estimated each indicator within the domains. The domains were combined by simple average of the z-scores and classified in quintiles (1-very low to 5-very high). Other methods (TRI, Macharia et al)1 found similar estimative.
ResultsThe SDI-COVID-19 estimated for the three moments of the pandemic (before (T0), first (T1) and second peak (T2)) in Brazil showed that municipalities belonging to the North and Northeast regions had worse SDI-Covid-19 compared to municipalities in the Midwest, Southeast, and South regions of the country. More than 97% of the municipalities in the North and Northeast regions had high and very high SDI in the three estimated periods. There was an increase of 46% in the number of municipalities in the Midwest region with high and very high SDI in T1 and 33% in T2 when compared to T0. Otherwise, we observed an increase of municipalities with very low and low SDI in T1 and T2 in the Southeast and South regions
ConclusionsThe deterministic linkage of administrative data allowed to build the SDI-COVID-19. This index identified the most vulnerable municipalities in the North and Northeast regions in contrast of municipalities in the Southeast and South regions of Brazil with lower inequalities during the pandemic. Findings can target policies to those areas.
A population-based approach to assessing diabetes management during COVID-19: insights from population data in Ontario, Canada.
Authors: Wodchis Walter , Bai Yuqing , Mondor Luke , Hall Ruth 
Published: August 2022

ObjectiveDiabetes management requires ongoing monitoring of diabetes care from primary care, specialist care and laboratory testing. COVID-19 led to changes in access to in-person care. The purpose of this research was to assess changes in the management of diabetes during the COVID-19 pandemic using population-linked datasets and population segmentation.
ApproachWe identified over 1.4 Million Ontarians with diabetes (approximately 10% of the population) with valid health insurance as of April 1, 2019 and April 1, 2020. We measured 11 indicators of diabetes management including laboratory testing for HbA1c and LDL (highlighted in this abstract). With screening indicators, we examined changes in the proportion of the population up-to-date with screening at the end of each fiscal year (March 31, 2020 and March 31, 2021) overall and according to population segments created using linked health data from primary care, home care, long term care and hospitals.
ResultsOverall screening rates that required laboratory testing for HbA1c and LDL fell substantially from 54% to 40% and 68% to 59% overall. Comparing across population segments, residents in Long Term Care facilities had the smallest changes in screening rates; individuals with low, medium and high complexity chronic conditions and end-of-life conditions had the largest changes; maternity, cancer, mental health and frail populations were in the middle. Differences according the primary care enrolment models (capitation vs fee-for-service) were relatively minor but patients who were not rostered to a primary care physician had the largest reductions in laboratory screening. Results for all 11 indicators will be shared in the presentation.
ConclusionCOVID-19 was associated with substantial reductions in laboratory-based diabetes screening. Poor diabetes management is one of the strongest risk-factors for adverse outcomes in COVID-19. Rates of diabetes management declined most for at risk patient populations amplifying the need to differentially connect with patients to ensure ongoing care during the pandemic.
Multi-jurisdictional Prostate Cancer Registry Linkage.
Authors: Radbone Christopher , Beckmann Kerri , Roder David , O'Callaghan Michael , Moretti Kim , Fitzgerald Liesel , Buckley Liz 
Published: August 2022

ObjectiveThe Prostate Cancer Outcomes Registry for Australian and New Zealand (PCOR-ANZ) aims to monitor population-wide prostate cancer characteristics, treatments, and outcomes. However, long-term follow-up of secondary treatments, disease progression, and side effects is limited. This novel project provides increased utility, enhancing this clinical registry by integrating national and jurisdictional data.
ApproachThe Tasmanian and South Australian jurisdictional registries (PCOR-Tas and PCOR-SA) are being treated as pilots for this nationally relevant data linkage project. Each contains descriptive data on clinical characteristics, primary treatments, survival, and patient-reported outcomes for prostate cancer in their jurisdictions. Data linkages include state-based hospital patient records and central cancer registries, with additional linkages to national data on prescribed medicines, procedures, and deaths; refer Figure 1.
Authorisation by contributing custodians and ethics committees, and funding from the Movember charity, has enabled the more detailed evaluation of patient follow-up after the initial treatment to examine historical trends, health service utilisation, disparities and gaps, and long-term patient outcomes.
ResultsSouth Australian study cohort consists of all men in the SACR (South Australia's central cancer registry) who were diagnosed with prostate cancer [ICD10=C61] as well as any additional men recorded in the PCOR-SA diagnosed from January 2002 to June 2021 (n=25,000). Men who do not have SA addresses recorded in either source are excluded from the South Australian pilot. The Tasmanian cohort is younger (established 2015) and smaller (n=2080), but for comparison is linked with the equivalent local and national datasets
The South Australian data linkage is being undertaken by SA NT DataLink, with the Tasmanian linkage undertaken by the Tasmania Data linkage Unit. For both jurisdictions, the national datasets are being linked by the Australian Institute for Health and Welfare (AIHW).
ConclusionSince the Australian health system involves components managed at both the State and Federal levels, multijurisdictional data linkage adds additional complexity to linkage projects. Undertaking this project was not without its challenges, but it demonstrates what can be achieved and the value of enhancing high-quality clinical registry data to address important outcomes in prostate cancer.