title: Avoiding doubles in distributed nominative medical databases: optimization of the needleman and wunsch algorithm.
abstract: Difficulties in reconstituting patients' trajectory in the public health information systems are raised by errors in patients' identification processes. A crucial issue to achieve is avoiding doubles in distributed web databases. We explored Needleman and Wunsch (N&W) algorithm in order to optimize the properties of string matching. Five variants of the N&W algorithm were developed. The algorithms were implemented for a web Multi-Source Information System. This system was dedicated to tracking patients with End-Stage Renal Disease at both regional and national level. A simulated study database of 73,210 records was created. An insertion or suppression of each character of the original string was simulated. The rate of double entries was 2% given an acceptable distance set to 5 modifications. The search was sensitive and specific with an acceptable detection time. It detected up to 10% of modifications that is above the estimated error rate. A variant of the N&W algorithm designed as "cut-off heuristic", proved to be efficient for the search of double entries occurring in nominative distributed databases.
authors.affiliation: Université Paris-Descartes, Faculté de Médecine; Assistance Publique-Hôpitaux de Paris; Hôpital Necker, EA222, Service de Biostatistique et d'Informatique Médicale, Hôpital Necker, 149 rue de Sèvres, Paris, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Le Mignot
authors.forename: Claude
authors.initials: C
authors.lastname: Mugnier
authors.forename: Mohamed Ben
authors.initials: MB
authors.lastname: Saïd
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jais
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Richard
authors.forename: Christine
authors.initials: C
authors.lastname: Le Bihan-Benjamin
authors.forename: Pierre
authors.initials: P
authors.lastname: Taupin
authors.forename: Paul
authors.initials: P
authors.lastname: Landais
mesh_terms: D000465:Algorithms; D003195:Computer Communication Networks; D016208:Databases, Factual; D006801:Humans