Validation of a hierarchical deterministic record-linkage algorithm using data from 2 different cohorts of human immunodeficiency virus-infected persons and mortality databases in Brazil.
Loss to follow-up is a major source of bias in cohorts of patients with human immunodeficiency virus (HIV) and could lead to underestimation of mortality. The authors developed a hierarchical deterministic linkage algorithm to be used primarily with cohorts of HIV-infected persons to recover vital status information for patients lost to follow-up. Data from patients known to be deceased in 2 cohorts in Rio de Janeiro, Brazil, and data from the Rio de Janeiro State mortality database for 1999-2006 were used to validate the algorithm. A fully automated procedure yielded a sensitivity of 92.9% and specificity of 100% when no information was missing. When the automated procedure was combined with clerical review, in a scenario of 5% death prevalence and 20% missing mothers' names, sensitivity reached 96.5% and specificity 100%. In a practical application, the algorithm significantly increased death rates and decreased the rate of loss to follow-up in the cohorts. The finding that 23.9% of matched records did not give HIV or acquired immunodeficiency syndrome as the cause of death reinforces the need to search all-cause mortality databases and alerts for possible underestimation of death rates. These results indicate that the algorithm is accurate enough to recover vital status information on patients lost to follow-up in cohort studies.
Programa de Computação Científica, Fundação Oswaldo Cruz, Avenida Brasil 4365, Manguinhos, 21045-360 Rio de Janeiro, Brazil. apacheco@fiocruz.br
Antonio G
AG
Pacheco
Valeria
V
Saraceni
Suely H
SH
Tuboi
Lawrence H
LH
Moulton
Richard E
RE
Chaisson
Solange C
SC
Cavalcante
Betina
B
Durovni
José C
JC
Faulhaber
Jonathan E
JE
Golub
Bonnie
B
King
Mauro
M
Schechter
Lee H
LH
Harrison
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D003644:Death Certificates; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000401:mortality*; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000401:mortality