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Abstract Background Childhood contact with social services is associated with a range of adverse mental health outcomes across the life course, yet there is limited evidence in relation to self-harm and suicidal or self-harm ideation. Aims Determine the association between all tiers of childhood contact with social services and presentation to an emergency department (ED) with self-harm or thoughts of suicide or self-harm (ideation) in young adulthood. Methods This retrospective cohort study linked population-wide administrative data on self-harm and ideation presentations recorded in the Northern Ireland Registry of Self-Harm (NIRSH) between 2012 and 2015 to primary care registrations and children’s social care data. Multilevel logistic regression models estimated the association between level of contact with social services in childhood (no contact; referred but assessed as not in need; child in need and child in care) and ED-presenting self-harm or ideation in young adulthood. Results There were 253,495 individuals born 1985–1993 with full data, alive and resident in Northern Ireland during 2012–2015 (ages 18–30 years). Of all young adults that presented to EDs with self-harm or ideation, 40.9% had contact with social services in childhood. Young adults with a history of care had 10-fold increased odds of self-harm or ideation (OR = 10.49 [95% CI, 9.45–11.66]) relative to those with no contact. Even those assessed as not in need of any help or support in childhood were three times more likely to present with self-harm or ideation (OR = 3.45 [95% CI, 3.07–3.88]). Conclusions Understanding the magnitude of childhood adversity amongst adults that present to EDs with self-harm or ideation may inform clinicians’ understanding and therapeutic decision-making. Whilst EDs provide an important setting in which to administer brief interventions, a multi-agency approach is required to reduce self-harm/ideation in young adults that had contact with social services in childhood.

Background Empirical evaluation of inverse probability weighting (IPW) for self-selection bias correction is inaccessible without the full source population. We aimed to: (i) investigate how self-selection biases frequency and association measures and (ii) assess self-selection bias correction using IPW in a cohort with register linkage. Methods The source population included 17 936 individuals invited to the Copenhagen Aging and Midlife Biobank during 2009–11 (ages 49–63 years). Participants counted 7185 (40.1%). Register data were obtained for every invited person from 7 years before invitation to the end of 2020. The association between education and mortality was estimated using Cox regression models among participants, IPW participants and the source population. Results Participants had higher socioeconomic position and fewer hospital contacts before baseline than the source population. Frequency measures of participants approached those of the source population after IPW. Compared with primary/lower secondary education, upper secondary, short tertiary, bachelor and master/doctoral were associated with reduced risk of death among participants (adjusted hazard ratio [95% CI]: 0.60 [0.46; 0.77], 0.68 [0.42; 1.11], 0.37 [0.25; 0.54], 0.28 [0.18; 0.46], respectively). IPW changed the estimates marginally (0.59 [0.45; 0.77], 0.57 [0.34; 0.93], 0.34 [0.23; 0.50], 0.24 [0.15; 0.39]) but not only towards those of the source population (0.57 [0.51; 0.64], 0.43 [0.32; 0.60], 0.38 [0.32; 0.47], 0.22 [0.16; 0.29]). Conclusions Frequency measures of study participants may not reflect the source population in the presence of self-selection, but the impact on association measures can be limited. IPW may be useful for (self-)selection bias correction, but the returned results can still reflect residual or other biases and random errors. [ABSTRACT FROM AUTHOR]

Deterioration of glycaemic control in people with long-standing diabetes mellitus (diabetes) may be a possible indicator of pancreatic cancer. However, the magnitude of the association between diabetes deterioration and pancreatic cancer has received little attention. We conducted a matched cohort study, nested within a population-based cohort of Australian women with diabetes. Women with unstable diabetes, defined as a change in medication after a 2-year period of stable medication use, were matched by birth year to those with stable diabetes, in a 1:4 ratio. We used flexible parametric survival models to estimate hazard ratios (HRs) and 95% confidence intervals (CI). We included 134,954 and 539,789 women in the unstable and stable diabetes cohorts, respectively (mean age 68 years). In total, 1,315 pancreatic cancers were diagnosed. Deterioration of stable diabetes was associated with a 2.5-fold increased risk of pancreatic cancer (HR 2.55; 95% CI 2.29–2.85). The risk was particularly high within the first year after diabetes deteriorated. HRs at 3 months, 6 months and 1 year were: 5.76 (95% CI 4.72–7.04); 4.56 (95% CI 3.81–5.46); and 3.33 (95% CI 2.86–3.89), respectively. The risk was no longer significantly different after 7 years. Deterioration in glycaemic control in people with previously stable diabetes may be an indicator of pancreatic cancer, suggesting investigations of the pancreas may be appropriate. The weaker longer-term (3–7 years) association between diabetes deterioration and pancreatic cancer may indicate that poor glycaemic control can be a risk factor for pancreatic cancer. [ABSTRACT FROM AUTHOR]

Background: Epilepsy significantly impacts on morbidity and mortality. Understanding hospitalization and mortality risks in persons with epilepsy (PWE) is essential for improving healthcare strategies. We aimed to investigate the risk and causes of hospitalization and mortality in PWE compared to a matched general population cohort., Methods: The EpiLink Bologna historical cohort study analyzed adult PWE in the period 2018-2019. A general population control cohort was used for comparison. Clinical data were linked with health administrative data. PWE were grouped into persons with focal epilepsy, idiopathic generalized epilepsy, and developmental and/or epileptic encephalopathy (PDEE). The primary outcome was the hospitalization rate. Emergency department (ED) visit rate and the risk of death for any cause were also assessed., Results: The study included 1438 PWE and 14,096 controls. PWE had higher incidence rate ratio (IRR) for ED visit (IRR 1.26, 95% CI 1.20-1.32), hospital admission (IRR 2.05, 95% CI 1.83-2.29), and death (IRR 1.5, 95% CI 1.1-2.2) compared to control cohort. The highest hospitalization risk was in the PDEE group (IRR 4.70; 95% CI 3.28-6.74). The increased hospitalization rate among PWE was due to both their higher ED visit and elective hospital admission rates. PWE on polytherapy were at higher risk of hospitalization for inflammation of jaw, acid-base/electrolyte imbalances, chronic cerebrovascular disease, major traumas and infections., Conclusions: During a 2-year-period, PWE in Bologna had a doubled risk of hospitalization and 50% higher risk of death compared to a matched general population cohort. Hospitalization risks varied significantly by epilepsy type and antiseizure therapy., (© 2025 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Abstract Background We introduce and study a recently proposed method for privacy-preserving distance computations which has received little attention in the scientific literature so far. The method, which is based on intersecting sets of randomly labeled grid points, is henceforth denoted as ISGP allows calculating the approximate distances between masked spatial data. Coordinates are replaced by sets of hash values. The method allows the computation of distances between locations L when the locations at different points in time t are not known simultaneously. The distance between $$L_1$$ L 1 and $$L_2$$ L 2 could be computed even when $$L_2$$ L 2 does not exist at $$t_1$$ t 1 and $$L_1$$ L 1 has been deleted at $$t_2$$ t 2 . An example would be patients from a medical data set and locations of later hospitalizations. ISGP is a new tool for privacy-preserving data handling of geo-referenced data sets in general. Furthermore, this technique can be used to include geographical identifiers as additional information for privacy-preserving record-linkage. To show that the technique can be implemented in most high-level programming languages with a few lines of code, a complete implementation within the statistical programming language R is given. The properties of the method are explored using simulations based on large-scale real-world data of hospitals ( $$n=850$$ n = 850 ) and residential locations ( $$n=13,000$$ n = 13 , 000 ). The method has already been used in a real-world application. Results ISGP yields very accurate results. Our simulation study showed that—with appropriately chosen parameters – 99 % accuracy in the approximated distances is achieved. Conclusion We discussed a new method for privacy-preserving distance computations in microdata. The method is highly accurate, fast, has low computational burden, and does not require excessive storage.

We utilized computerized record-linkage methods to link HIV and cancer databases with limited unique identifiers in Pune, India, to determine feasibility of linkage and obtain preliminary estimates of cancer risk in persons living with HIV (PLHIV) as compared with the general population.Records of 32,575 PLHIV were linked to 31,754 Pune Cancer Registry records (1996-2008) using a probabilistic-matching algorithm. Cancer risk was estimated by calculating standardized incidence ratios (SIRs) in the early (4-27 months after HIV registration), late (28-60 months), and overall (4-60 months) incidence periods. Cancers diagnosed prior to or within 3 months of HIV registration were considered prevalent.Of 613 linked cancers to PLHIV, 188 were prevalent, 106 early incident, and 319 late incident. Incident cancers comprised 11.5% AIDS-defining cancers (ADCs), including cervical cancer and non-Hodgkin lymphoma (NHL), but not Kaposi sarcoma (KS), and 88.5% non-AIDS-defining cancers (NADCs). Risk for any incident cancer diagnosis in early, late, and combined periods was significantly elevated among PLHIV (SIRs: 5.6 [95% CI 4.6-6.8], 17.7 [95% CI 15.8-19.8], and 11.5 [95% CI 10-12.6], respectively). Cervical cancer risk was elevated in both incidence periods (SIRs: 9.6 [95% CI 4.8-17.2] and 22.6 [95% CI 14.3-33.9], respectively), while NHL risk was elevated only in the late incidence period (SIR: 18.0 [95% CI 9.8-30.20]). Risks for NADCs were dramatically elevated (SIR > 100) for eye-orbit, substantially (SIR > 20) for all-mouth, esophagus, breast, unspecified-leukemia, colon-rectum-anus, and other/unspecified cancers; moderately elevated (SIR > 10) for salivary gland, penis, nasopharynx, and brain-nervous system, and mildly elevated (SIR > 5) for stomach. Risks for 6 NADCs (small intestine, testis, lymphocytic leukemia, prostate, ovary, and melanoma) were not elevated and 5 cancers, including multiple myeloma not seen.Our study demonstrates the feasibility of using probabilistic record-linkage to study cancer/other comorbidities among PLHIV in India and provides preliminary population-based estimates of cancer risks in PLHIV in India. Our results, suggesting a potentially substantial burden and slightly different spectrum of cancers among PLHIV in India, support efforts to conduct multicenter linkage studies to obtain precise estimates and to monitor cancer risk in PLHIV in India.

A recent paper suggested all women with endometrial cancer should take statins but it is unclear whether there is sufficient evidence to justify this recommendation. We identified all women diagnosed with uterine cancer in Australia between July 2003 and December 2013 (2012 in New South Wales) through the Australian Cancer Database (N = 16,501) and linked these to the national prescription database and National Death Index to identify statin use and survival outcomes to December 2015. We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations between statin use and survival. Among the 15,703 women with endometrial cancer, pre-diagnosis statin use was not associated with survival. Endometrial cancer-specific mortality was lower among women who used statins after diagnosis (time-varying models: HR = 0.92; 95%CI 0.82–1.03) but the association was only seen among women with type 1 cancers (0.87; 0.76–1.00), for hydrophilic statins (0.84; 0.68–1.03) and for new use of statins after diagnosis (0.75; 0.59–0.95). There was a weak dose-response with increasing number of statin prescriptions. Sensitivity analyses using inverse probability of treatment weights were similar. Women with endometrial cancer who take statins after diagnosis may have better survival than those who do not use statins. However, it is impossible to completely rule out bias, particularly reverse causation where disease status may affect statin use. We believe it is too early to recommend all women with endometrial cancer take statins, but there is sufficient evidence to justify a randomized trial. • This national data-linkage study confirms a potential survival benefit for use of statins by women with endometrial cancer. • However, it is impossible to eliminate all bias, particularly reverse causation where disease status may affect statin use. • It is too early to recommend all women with endometrial cancer take statins, but a randomized trial is justified. [ABSTRACT FROM AUTHOR]

Background: We introduce and study a recently proposed method for privacy-preserving distance computations which has received little attention in the scientific literature so far. The method, which is based on intersecting sets of randomly labeled grid points, is henceforth denoted as ISGP allows calculating the approximate distances between masked spatial data. Coordinates are replaced by sets of hash values. The method allows the computation of distances between locations L when the locations at different points in time t are not known simultaneously. The distance between L 1 and L 2 could be computed even when L 2 does not exist at t 1 and L 1 has been deleted at t 2 . An example would be patients from a medical data set and locations of later hospitalizations. ISGP is a new tool for privacy-preserving data handling of geo-referenced data sets in general. Furthermore, this technique can be used to include geographical identifiers as additional information for privacy-preserving record-linkage. To show that the technique can be implemented in most high-level programming languages with a few lines of code, a complete implementation within the statistical programming language R is given. The properties of the method are explored using simulations based on large-scale real-world data of hospitals ( n = 850 ) and residential locations ( n = 13 , 000 ). The method has already been used in a real-world application. Results: ISGP yields very accurate results. Our simulation study showed that—with appropriately chosen parameters – 99 % accuracy in the approximated distances is achieved. Conclusion: We discussed a new method for privacy-preserving distance computations in microdata. The method is highly accurate, fast, has low computational burden, and does not require excessive storage. [ABSTRACT FROM AUTHOR]

Insulin‐like growth factor‐I (IGF‐I) and testosterone may be related to prostate cancer risk. Acromegaly is associated with clinically high IGF‐I concentrations. Klinefelter's syndrome, testicular hypofunction and hypopituitarism are associated with clinically low testosterone concentrations. We aimed to investigate whether diagnosis with these conditions was associated with subsequent prostate cancer diagnosis and mortality. We used linked English national Hospital Episode Statistics and mortality data from 1999 to 2017 to construct and follow‐up cohorts of men aged ≥35 years diagnosed with (i) acromegaly (n = 2,495) and (ii) hypogonadal‐associated diseases (n = 18,763): Klinefelter's syndrome (n = 1,992), testicular hypofunction (n = 8,086) and hypopituitarism (n = 10,331). We estimated adjusted hazard ratios (HRs) and confidence intervals (CIs) for prostate cancer diagnosis and death using Cox regression in comparison with an unexposed reference cohort of 4.3 million men, who were admitted to hospital for a range of minor surgeries and conditions (n observed cases = 130,000, n prostate cancer deaths = 30,000). For men diagnosed with acromegaly, HR for prostate cancer diagnosis was 1.33 (95% CI 1.09–1.63; p = 0.005; n observed cases = 96), HR for prostate cancer death was 1.44 (95% CI 0.92–2.26; p = 0.11; n deaths = 19). Diagnosis with Klinefelter's syndrome was associated with a lower prostate cancer risk (HR = 0.58, 95% CI 0.37–0.91; p = 0.02; n observed cases = 19) and hypopituitarism was associated with a reduction in prostate cancer death (HR = 0.53, 95% CI 0.35–0.79; p = 0.002; n deaths = 23). These results support the hypothesised roles of IGF‐I and testosterone in prostate cancer development and/or progression. These findings are important because they provide insight into prostate cancer aetiology. What's new? Although the incidence rates of prostate cancer vary globally, little is known about modifiable risk factors. Previous studies have shown insulin‐like growth factor‐I (IGF‐I) and testosterone may be related to prostate cancer risk. Using national hospital admission data, the authors examined whether these associations are consistent across clinical extremes in comparison with a reference cohort. Men diagnosed with acromegaly (characterised by high IGF‐I) had an increased risk of incident prostate cancer, while men diagnosed with diseases characterised by low testosterone had a lower risk of prostate cancer mortality. The findings support the role of IGF‐I and testosterone in prostate cancer pathogenesis. [ABSTRACT FROM AUTHOR]

Surveys are key means of obtaining policy-relevant information not available from routine sources. Bias arising from non-participation is typically handled by applying weights derived from limited socio-demographic characteristics. This approach neither captures nor adjusts for differences in health and related behaviours between participants and non-participants within categories. We addressed non-participation bias in alcohol consumption estimates using novel methodology applied to 2003 Scottish Health Survey responses record-linked to prospective administrative data. Differences were identified in socio-demographic characteristics, alcohol-related harm (hospitalisation or mortality) and all-cause mortality between survey participants and, from unlinked administrative sources, the contemporaneous general population of Scotland. These were used to infer the number of non-participants within each subgroup defined by socio-demographics and health outcomes. Synthetic observations for non-participants were then generated, missing only alcohol consumption. Weekly alcohol consumption values among synthetic non-participants were multiply imputed under missing at random and missing not at random assumptions. Relative to estimates adjusted using previously derived weights, the obtained mean weekly alcohol intake estimates were up to 59% higher among men and 16% higher among women, depending on the assumptions imposed. This work demonstrates the universal value of multiple imputation-based methodological advancement incorporating administrative health data over routine weighting procedures. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies investigating the mental health of migrants have shown mixed results. The increased availability of register data has led to a growing number of register-based studies in this research area. This is the first scoping review on the use of registry and record-linkage data to examine the mental health of migrant populations. The aim of this scoping review is to investigate the topics covered and to assess the results yielded from these studies. Methods We used a scoping review methodology to search MedLine, PubMed, PsychINFO, Web of Science, and SCOPUS for all register-based studies on the mental health of migrants. Two reviewers screened all papers, independently, using iteratively applied inclusion and exclusion criteria. Using gradually broadening inclusion and exclusion criteria for maximum “scope,” newly published criteria developed to appraise the methodological quality of record-linkage studies were applied to eligible papers and data were extracted in a charting exercise. Results A total of 1309 papers were screened and appraised, 51 of which met the eligibility and quality criteria and were included in the review. This review identified four major domains of register-based research within the topic of migrant mental health: rates and risks of psychiatric disorders, rates and risks of suicide mortality, the use of psychotropic drugs, and health service utilisation and mental health-related hospitalisation rates. We found that whilst migrants can be at an increased risk of developing psychotic disorders and suicide mortality, they are less likely to use psychotropic medication and mental health-related services. Conclusions This review systematically charts the register-based studies on migrants’ mental health for the first time. It shows the main topics and gaps in knowledge in this research domain, discusses the disadvantages of register-based studies, and suggests new directions for forthcoming studies.

Introduction: It is anticipated that by 2030 the number of older people and people living with long term conditions will have significantly increased. At the same time, it is expected that there will be a shift to providing more health care in the community. Browning et al [1] using a prospective 16-year longitudinal study of 1000 older Australians described three ageing groups (i) ageing well (30%); initially ageing well then deteriorating (50%); consistently ageing poorly (20%). Understanding the predictors of services use in older people is important in planning and providing quality care. Predictors of general practice service use from a small community-based studies have included: lower age, fewer medical conditions, restful sleep, good nutrition, decreased stress, being a non-smoker and good social support [2]. Using our existing data linkage resource, the Central and Eastern Sydney Primary and Community Health Cohort/Resource (CES-P&CH), which includes questionnaire data, primary care records, prescribing information, hospital records, emergency department records, cancer registry, and vital statistics on over 30,000 participants in CES aged 45 years and over (over 250,000 in NSW for comparison) we identified the predictors of service use (including general practice, pharmaceuticals, emergency departments, hospitalisations) amongst people aged over 75 years. Methods: A record linkage study using 45 and Up Study questionnaire data, MBS claims, PBS claims, Emergency Department visits, hospitalisations and deaths was undertaken. Participant characteristics at baseline (2006-2009) included demographics, health behaviours, social capital, functional status, and health conditions. Service characteristics included type of service, length of stay, location. Predictive models were developed to examine the participant/service characteristics with higher/lower service use over time. Results and Discussion: We identified 6,067 participants who were aged over 75 years in CES at baseline. Of these 59.0% had seen a GP 8 times or more in 2008, 19.6% had seen a specialist 8 times or more, 26.7% had attended an ED at least once, and 44.2% had been hospitalised at least once. In 2014 rates of GP use, specialist use and hospital admissions remained the same however ED visits had increased by 5%. This paper will discuss the different predictive models that were developed to describe service use. This paper will also provide the results from the predictive models and how this information is being/can be used to better plan and provide quality care for older people in CES. Limitations and suggestions for future research: Because the research study used an existing record linkage resource we were limited to the participant and service characteristics that were available. This research study would benefit from the inclusion on non-admitted data such as outpatient, community services and aged care services. References: 1- Browning C, Enticott J, Thomas S and Kendig H. 2017. Trajectories of ageing well among older Australians: a 16-year longitudinal study. Ageing and Society. 2017; 1-22. 2 -Korten AE, Jacomb PA, Jiao Z, Christensen H, Jorm AF, Henderson AS, Rodgers B. Predictors of GP service use: a community survey of an elderly Australian sample. Aust N Z J Public Health. 1998; 22: 609-615.

Introduction: In Australia there has been a sharp increase in the proportion of older people who live alone. Living alone increases the risk of being socially isolated or experiencing loneliness. Older people who are lonely have an increased risk of dying sooner and are more likely to experience a decline in their mobility [1]. Understanding if and how social isolation/loneliness impacts on managing health conditions and use of health services is important in providing quality care and preventing premature mortality. Living alone is not necessarily a predictor of social isolation/loneliness, rather lack of time spent with family or friend may be a better indicator. More supportive social relationships are related to a decreased mortality risk [2]. Research has been undertaken on the determinants of isolation/loneliness (individual, social, community and environment), however less emphasis has occurred on the medical determinants and how these might be mitigated. Using our existing data linkage resource, the Central and Eastern Sydney Primary and Community Health Cohort/Resource (CES-P&CH), which includes questionnaire data, primary care records, prescribing information, hospital records, emergency department records, cancer registry, and vital statistics on over 30,000 participants in CES aged 45 years and over we explored patterns of service use in people who are socially isolated. Methods: A record linkage study using 45 and Up Study questionnaire data, MBS claims, hospitalisations and deaths was undertaken. Social isolation was defined using a combination of baseline questionnaire data on living arrangements, family and friend support, and health issues that impacted on work/daily activities. Participant characteristics and health conditions at baseline (2006-2009) and health service use (including GP presentations, care plan use, and number and frequency of hospitalisations over the next 10 years) were compared for those who were defined as socially isolated versus those who were not using multivariate/time series models. Results and Discussion: At baseline 20% of participant lived alone; 30.8% had no partner; 18.5% had no children; 44.3% were not working; 4.9% regularly need help with daily tasks; 12.0% had severe physical limitations; 8.8% did not have support from family or friends; 9.6% were urinary incontinent, and 11.3% had depression or anxiety. These participants were included in the socially isolated group for the analysis if they had multiple risks. This paper will discuss the different algorithms that were developed to describe social isolation. This paper will also provide the results from the multivariate/time series models and how this information is being/can be used to better understand and provide person-centred quality care in CES. Limitations and suggestions for future research: Because the research study used an existing record linkage resource we were limited to the items that were included in the questionnaire to define social isolations. This research study would benefit from sensitivity testing of the resultant social isolation algorithm. References: 1- Perissinotto CM, Stijacic CI, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med 2012;172(14):1078-83. 2- Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. PLoS Med 2010;7(7): e1000316. doi:10.1371/journal.pmed.1000316

Background: Self-harm is common, debilitating and associated with completed suicide and increased all-cause mortality, but there is uncertainty about its causal risk factors, limiting risk assessment and effective management. Neuroticism is a stable personality trait associated with self-harm and suicidal ideation, and correlated with coping styles, but its value as an independent predictor of these outcomes is disputed.Methods: Prior history of hospital-treated self-harm was obtained by record-linkage to administrative health data in Generation Scotland:Scottish Family Health Study (N = 15,798; self-harm cases = 339) and by a self-report variable in UK Biobank (N = 35,227; self-harm cases = 772). Neuroticism in both cohorts was measured using the Eysenck Personality Questionnaire-Short Form. Associations of neuroticism with self-harm were tested using multivariable regression following adjustment for age, sex, cognitive ability, educational attainment, socioeconomic deprivation, and relationship status. A subset of GS:SFHS was followed-up with suicidal ideation elicited by self-report (n = 3342, suicidal ideation cases = 158) and coping styles measured by the Coping Inventory for Stressful Situations. The relationship of neuroticism to suicidal ideation, and the role of coping style, was then investigated using multivariable logistic regression.Results: Neuroticism was positively associated with hospital-associated self-harm in GS:SFHS (per EPQ-SF unit odds ratio 1.2 95% credible interval 1.1-1.2, pFDR 0.0003) and UKB (per EPQ-SF unit odds ratio 1.1 95% confidence interval 1.1-1.2, pFDR 9.8 × 10-17). Neuroticism, and the neuroticism-correlated coping style, emotion-oriented coping (EoC), were also associated with suicidal ideation in multivariable models.Conclusions: Neuroticism is an independent predictor of hospital-treated self-harm risk. Neuroticism and emotion-orientated coping styles are also predictive of suicidal ideation. [ABSTRACT FROM AUTHOR]

• Uptake of rotavirus vaccine is suboptimal compared to other co-administered infant vaccines. • The upper age restriction for rotavirus vaccine is the main driver of lower coverage. • Compared to non-Aboriginal infants, vaccine uptake lower in Aboriginal infants. • Preterm and low birthweight infants associated with the lowest uptake of rotavirus vaccine. • Other factors include higher birth order, younger maternal age, caesarean birth. Rotavirus vaccines (RV), included in Australia's National Immunisation Program from mid-July 2007, are unique in strict time limits for administration. Here, we report on timeliness of RV uptake, compare cumulative RV coverage to age 12 months with DTPa, and assess factors associated with receipt of RV among Aboriginal and non-Aboriginal children. Birth records for 681,456 children born in two Australian states in 2007–2012 were probabilistically linked to national immunisation records. We assessed on-time coverage (defined as receipt of vaccine dose between 4 days prior to scheduled date and the recommended upper limit) for RV and compared this to diphtheria-tetanus-pertussis (DTPa) vaccine. Logistic regression modelling was used to assess independent determinants of receipt of RV. Compared to non-Aboriginal infants, on-time RV coverage was lower for all doses among Aboriginal infants. Post the upper age limit of RV dose2, DTPa dose2 coverage increased by 9–16% to ≥90%, whereas RV coverage remained around 77% (Aboriginal) and 85% (non-Aboriginal). Compared to first-born children, the adjusted odds of receiving ≥1 RV dose if born to a mother with ≥3 previous births was 0.30 (95%CI: 0.27–0.34) among Aboriginal, and 0.53 (95%CI: 0.51–0.55) among non-Aboriginal children. Prematurity (<33 weeks), low birthweight (<1500 g), maternal age <20 years, maternal smoking during pregnancy and living in a disadvantaged area were independently associated with decreased vaccine uptake. Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher. Although specific programs targeting groups at risk of delayed vaccination might improve RV coverage, relaxation of upper age restrictions is most readily implementable, and its overall risk-benefit should be evaluated. [ABSTRACT FROM AUTHOR]

Objectives: Antidepressants are the most commonly prescribed psychiatric medication but concern has been raised about significant increases in their usage in high income countries. We aimed to quantify antidepressant prevalence, incidence, adherence and predictors of use in the adult population.Methods: The study record-linked administrative prescribing and morbidity data to the Generation Scotland cohort ( N = 11,052), between 2009 and 2016. Prevalence and incidence of any antidepressant use was determined. Antidepressant adherence was measured using Proportion of Days Covered and Medication Possession Ratio. Time-to-event analysis for incident antidepressant use within 5 years of Generation Scotland: Scottish Family Health Study (GS:SFHS) recruitment was performed to reveal patient-level predictors of use.Results: Almost one-third (28.0%, 95%CI 26.9-29.1) of the adults in our sample were prescribed at least one antidepressant in the 5-year period 2012-2016. There was a 36.2% increase in annual prevalence between 2010 and 2016. Incidence was 2.4(2.1-2.7)% per year. The majority of antidepressant episodes (57.6%) were greater than 9 months duration and adherence was generally high (69.0% with Proportion of Days Covered >80%). Predictors of new antidepressant use included history of affective disorder, being female, physical comorbidities, higher neuroticism scores, and lower cognitive function scores.Conclusions: Antidepressant prevalence is greater than previously reported but incidence remains relatively stable. We found the majority of antidepressant episodes to be of relatively long duration with good estimated adherence. Our study supports the hypothesis that increased long-term use among existing (and returning) users, along with wider ranges of indications for antidepressants, has significantly increased the prevalence of these medications. [ABSTRACT FROM AUTHOR]

Background: Deterioration of glycaemic control in people with long-standing diabetes mellitus (diabetes) may be a possible indicator of pancreatic cancer. However, the magnitude of the association between diabetes deterioration and pancreatic cancer has received little attention., Methods: We conducted a matched cohort study, nested within a population-based cohort of Australian women with diabetes. Women with unstable diabetes, defined as a change in medication after a 2-year period of stable medication use, were matched by birth year to those with stable diabetes, in a 1:4 ratio. We used flexible parametric survival models to estimate hazard ratios (HRs) and 95% confidence intervals (CI)., Results: We included 134,954 and 539,789 women in the unstable and stable diabetes cohorts, respectively (mean age 68 years). In total, 1,315 pancreatic cancers were diagnosed. Deterioration of stable diabetes was associated with a 2.5-fold increased risk of pancreatic cancer (HR 2.55; 95% CI 2.29-2.85). The risk was particularly high within the first year after diabetes deteriorated. HRs at 3 months, 6 months and 1 year were: 5.76 (95% CI 4.72-7.04); 4.56 (95% CI 3.81-5.46); and 3.33 (95% CI 2.86-3.89), respectively. The risk was no longer significantly different after 7 years., Conclusions: Deterioration in glycaemic control in people with previously stable diabetes may be an indicator of pancreatic cancer, suggesting investigations of the pancreas may be appropriate. The weaker longer-term (3-7 years) association between diabetes deterioration and pancreatic cancer may indicate that poor glycaemic control can be a risk factor for pancreatic cancer., (Copyright © 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Background: Although income level may play a significant part in mortality among migrants, previous research has not focused on the relationship between income, migration and mortality risk. The aim of this register study was to compare all-cause mortality by income level between different migrant groups and the majority settled population of Finland. Methods: A random sample was drawn of 1,058,391 working age people (age range 18–64 years; 50.4% men) living in Finland in 2000 and linked to mortality data from 2001 to 2014. The data were obtained from Statistics Finland. Cox proportional hazards models were used to investigate the association between region of origin and all-cause mortality in low- and high-income groups. Results: The risk for all-cause mortality was significantly lower among migrants than among the settled majority population (hazards ratio (HR) 0.57; 95% confidence interval (CI) 0.53–0.62). After adjustment for age, sex, marital status, employment status and personal income, the risk of mortality was significantly reduced for low-income migrants compared with the settled majority population with a low income level (HR 0.46; 95% CI 0.42–0.50) and for high-income migrants compared with the high-income settled majority (HR 0.81; 95% CI 0.69–0.95). Results comparing individual high-income migrant groups and the settled population were not significant. Low-income migrants from Africa, the Middle East and Asia had the lowest mortality risk of any migrant group studied (HR 0.32; 95% CI 0.27–0.39). Conclusions: Particularly low-income migrants seem to display a survival advantage compared with the corresponding income group in the settled majority population. Downward social mobility, differences in health-related lifestyles and the healthy migrant effect may explain this phenomenon. [ABSTRACT FROM AUTHOR]

Background and aims Analytical approaches to addressing survey non-participation bias typically use only demographic information to improve estimates. We applied a novel methodology which uses health information from data linkage to adjust for non-representativeness. We illustrate the method by presenting adjusted alcohol consumption estimates for Scotland. Design Data on consenting respondents to the Scottish Health Surveys (SHeSs) 1995-2010 were linked confidentially to routinely collected hospital admission and mortality records. Synthetic observations representing non-respondents were created using general population data. Multiple imputation was performed to compute adjusted alcohol estimates given a range of assumptions about the missing data. Adjusted estimates of mean weekly consumption were additionally calibrated to per-capita alcohol sales data. Setting Scotland. Participants 13 936 male and 18 021 female respondents to the SHeSs 1995-2010, aged 20-64 years. Measurements Weekly alcohol consumption, non-, binge- and problem-drinking. Findings Initial adjustment for non-response resulted in estimates of mean weekly consumption that were elevated by up to 17.8% [26.5 units (18.6-34.4)] compared with corrections based solely on socio-demographic data [22.5 (17.7-27.3)]; other drinking behaviour estimates were little changed. Under more extreme assumptions the overall difference was up to 53%, and calibrating to sales estimates resulted in up to 88% difference. Increases were especially pronounced among males in deprived areas. Conclusions The use of routinely collected health data to reduce bias arising from survey non-response resulted in higher alcohol consumption estimates among working-age males in Scotland, with less impact for females. This new method of bias reduction can be generalized to other surveys to improve estimates of alternative harmful behaviours. [ABSTRACT FROM AUTHOR]

Background: Previous studies investigating the mental health of migrants have shown mixed results. The increased availability of register data has led to a growing number of register-based studies in this research area. This is the first scoping review on the use of registry and record-linkage data to examine the mental health of migrant populations. The aim of this scoping review is to investigate the topics covered and to assess the results yielded from these studies. Methods: We used a scoping review methodology to search MedLine, PubMed, PsychINFO, Web of Science, and SCOPUS for all register-based studies on the mental health of migrants. Two reviewers screened all papers, independently, using iteratively applied inclusion and exclusion criteria. Using gradually broadening inclusion and exclusion criteria for maximum "scope," newly published criteria developed to appraise the methodological quality of record-linkage studies were applied to eligible papers and data were extracted in a charting exercise. Results: A total of 1309 papers were screened and appraised, 51 of which met the eligibility and quality criteria and were included in the review. This review identified four major domains of register-based research within the topic of migrant mental health: rates and risks of psychiatric disorders, rates and risks of suicide mortality, the use of psychotropic drugs, and health service utilisation and mental health-related hospitalisation rates. We found that whilst migrants can be at an increased risk of developing psychotic disorders and suicide mortality, they are less likely to use psychotropic medication and mental health-related services. Conclusions: This review systematically charts the register-based studies on migrants' mental health for the first time. It shows the main topics and gaps in knowledge in this research domain, discusses the disadvantages of register-based studies, and suggests new directions for forthcoming studies. [ABSTRACT FROM AUTHOR]

Background: Clinical anecdote suggests that rates of eating disorders (ED) vary between schools. Given their high prevalence and mortality, understanding risk factors is important. We hypothesised that rates of ED would vary between schools, and that school proportion of female students and proportion of parents with post-high school education would be associated with ED, after accounting for individual characteristics.Method: Multilevel analysis of register-based, record-linkage data on 55 059 females born in Stockholm County, Sweden, from 1983, finishing high school in 2002-10. Outcome was clinical diagnosis of an ED, or attendance at a specialist ED clinic, aged 16-20 years.Results: The 5-year cumulative incidence of ED diagnosis aged 16-20 years was 2.4%. Accounting for individual risk factors, with each 10% increase in the proportion of girls at a school, the odds ratio for ED was 1.07 (1.01 to 1.13), P = 0.018. With each 10% increase in the proportion of children with at least one parent with post-high school education, the odds ratio for ED was 1.14 (1.09 to 1.19), P < 0.0001. Predicted probability of an average girl developing an ED was 1.3% at a school with 25% girls where 25% of parents have post-high school education, and 3.3% at a school with 75% girls where 75% of parents have post-high school education.Conclusions: Rates of ED vary between schools; this is not explained by individual characteristics. Girls at schools with high proportions of female students, and students with highly educated parents, have higher odds of ED regardless of individual risk factors. [ABSTRACT FROM AUTHOR]

Purpose Research using dispensing claims is used increasingly to study post-market medicines use and outcomes. The purpose of this review is to catalogue more than 25 years of published literature using Australia's Pharmaceutical Benefits Scheme (PBS) dispensing records. Methods We searched MEDLINE, PreMEDLINE and Embase and conducted author searches for studies published from 1987 to 2013. Independent reviewers screened abstracts of 3209 articles and reviewed 264 full-text manuscripts. Included studies used PBS dispensing data to measure patterns and/or outcomes of prescribed medicines use or dispensing claims to derive a proxy for a specific disease cohort or health outcome. Results Of the 228 studies identified, 106 used PBS claims only (56 using claims-level data and 50 using individual-level data) and 63 studies linked individual-level PBS claims to other health data. Most commonly, studies examined trends in drug utilisation (33%), clinician and patient practices (26%), drug use and outcomes (18%) and evaluations of intervention impacts (17%). Sixty-two percent of studies using individual-level data were based on a subset of elderly Australians. Most studies focused on drug classes acting on the nervous system (36%), cardiovascular system (15%) and alimentary tract (11%). Few studies examined prescribed medicines use in children and pregnant women. Conclusions Pharmaceutical Benefits Scheme claims represent a significant resource to examine Australia's billion-dollar annual investment in prescribed medicines. The body of research is growing and has increased in complexity over time. Australia has great potential to undertake world-class, whole-of-population pharmacoepidemiological studies. Recent investment in data linkage infrastructure will significantly enhance these opportunities. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Commercial organizations and government agencies that gather, store, share and disseminate data are facing increasing concerns over individual privacy and confidentiality. Confidential data is often masked in the database or prior to release to a third party, through methods such as data perturbation. In this study, reidentification risks of three major additive data perturbation techniques were compared using two different record linkage techniques. The results suggest that re-identification risk of Kim's multivariate noise addition method is similar to that of simple noise addition method. The general additive perturbation method (GADP) has the lowest re-identification risk and therefore provides the highest level of protection. The study also suggests that Fuller's method of assessing re-identification risk may be better suited than the probabilistic record-linkage method of Winkler, for numeric data. The results of this study should be help organizations and government agencies choose an appropriate additive perturbation technique. [ABSTRACT FROM AUTHOR]

Aims: The bidirectional association between diabetes mellitus (DM) and pancreatic cancer (PC) is established; however, the strength of association between duration of DM and risk of PC needs further investigation., Methods: We conducted a case-control study nested within a population-based cohort of Australian women established using record linkage. Women diagnosed with PC from July 2007 to December 2013, were matched to five controls based on age and state of residence. DM was defined according to prescription of anti-diabetic medication from administrative prescription data. We used conditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI), adjusted for area-level socioeconomic status, rurality of residence, weighted comorbidity score, and predicted probability of obesity., Results: The analyses included 7,267 cases and 35,978 controls. The mean age at the time of DM diagnosis was 71 years whereas the mean age at the time of diagnosis of PC was 76 years. A history of DM of any duration was associated with a 2-fold increase in risk of PC (OR=2.12; 95%CI:1.96-2.29) compared to having no history of DM. The risk decreased with increasing duration of DM. The highest risk was in those who had recent-onset DM (OR=8.08; 95%CI:6.88-9.50 for <12 months of DM), but the risk remained elevated with ≥5 years of DM (OR=1.40; 95%CI:1.27-1.55)., Conclusion: The markedly increased risk of PC in those with recent-onset DM emphasises the need for further research to distinguish patients for whom new-onset DM is a manifestation of PC from those with type-2 DM. The elevated risk associated with long-standing DM suggests that preventing DM may contribute to a reduction in the incidence of PC., Competing Interests: Declaration of interest PM Webb has received grant funding from AstraZeneca (who make anti-diabetic medications) for a study of ovarian cancer and also a speakers fee from AstraZeneca (in 2021); the remaining authors declare no conflicts of interest related to the submitted work., (Copyright © 2022. Published by Elsevier Ltd.)

Administrative records are increasingly being linked to survey records to highten the utility of the survey data. Respondent consent is usually needed to perform exact record linkage; however, not all respondents agree to this request and several studies have found significant differences between consenting and non-consenting respondents on the survey variables. To the extent that these survey variables are related to variables in the administrative data, the resulting administrative estimates can be biased due to non-consent. Estimating non-consent biases for linked administrative estimates is complicated by the fact that administrative records are typically not available for the non-consenting respondents. The present study can overcome this limitation by utilizing a unique data source, the German Panel Study "Labour Market and Social Security" (PASS), and linking the consent indicator to the administrative records (available for the entire sample). This situation permits the estimation of non-consent biases for administrative variables and avoids the need to link the survey responses. The impact of non-consent bias can be assessed relative to other sources of bias (nonresponse, measurement) for several administrative estimates. The results show that non-consent biases are present for few estimates, but are generally small relative to other sources of bias.

ABSTRACT Purpose All five Nordic countries have nationwide prescription databases covering all dispensed drugs, with potential for linkage to outcomes. The aim of this review is to present an overview of therapeutic areas studied and methods applied in pharmacoepidemiologic studies using data from these databases. Methods The study consists of a Medline-based structured literature review of scientific papers published during 2005-2010 using data from the prescription databases in Denmark, Finland, Iceland, Norway, and Sweden, covering 25 million inhabitants. Relevant studies were analyzed in terms of pharmacological group, study population, outcomes examined, type of study (drug utilization vs. effect of drug therapy), country of origin, and extent of cross-national collaboration. Results A total of 515 studies were identified. Of these, 262 were conducted in Denmark, 97 in Finland, 4 in Iceland, 87 in Norway, and 61 in Sweden. Four studies used data from more than one Nordic country. The most commonly studied drugs were those acting on the nervous system, followed by cardiovascular drugs and gastrointestinal/endocrine drugs. A total of 228 studies examined drug utilization and 263 focused on the effects and safety of drug therapy. Pregnant women were the most commonly studied population in safety studies, whereas prescribers' adherence to guidelines was the most frequent topic of drug utilization studies. Conclusions The Nordic prescription databases, with their possibility of record-linkage, represent an outstanding resource for assessing the beneficial and adverse effects of drug use in large populations, under routine care conditions, and with the potential for long-term follow-up. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Multiple sclerosis (MS) and epilepsy are both fairly common and it follows that they may sometimes occur together in the same people by chance. We sought to determine whether hospitalisation for MS and hospitalisation for epilepsy occur together more often than expected by chance alone. Methods We analysed two datasets of linked statistical hospital admission records covering the Oxford Record Linkage Study area (ORLS, 1963-1998) and all England (1999-2011). In each, we calculated the rate of occurrence of hospital admission for epilepsy in people after admission for MS, compared with equivalent rates in a control cohort, and expressed the results as a relative risk (RR). Results The RR for hospital admission for epilepsy following an admission for MS was significantly high at 4.1 (95% confidence interval 3.1-5.3) in the ORLS and 3.3 (95% CI 3.1-3.4) in the all-England cohort. The RR for a first recorded admission for epilepsy 10 years and more after first recorded admission for MS was 4.7 (2.8-7.3) in ORLS and 3.9 (3.1-4.9) in the national cohort. The RR for the converse-MS following hospitalisation for epilepsy-was 2.5 (95% CI 1.7-3.5) in the ORLS and 1.9 (95% CI 1.8-2.1) in the English dataset. Conclusions MS and epilepsy occur together more commonly than by chance. One possible explanation is that an MS lesion acts as a focus of an epileptic seizure; but other possibilities are discussed. Clinicians should be aware of the risk of epilepsy in people with MS. The findings may also suggest clues for researchers in developing hypotheses about underlying mechanisms for the two conditions. [ABSTRACT FROM AUTHOR]

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Rationale, aims and objectives Record linkage (RL) has become increasingly useful in health care administration, demographic studies, provision of health statistics and medical research. Linkage failure may occur when databases are affected by missing or inaccurate information. In particular, if the subsets of those who are not linked are not representative of the original population, the results obtained from linked data may be biased. This paper discusses the impact of incomplete RL on survival analysis. Methods In our study we assess by simulations the potential impact of such bias, that we will refer to as RL, on the effect of the covariates in the Cox regression model. We also evaluate the RL bias introduced by an incomplete linkage procedure on the analysis of survival in a cohort of patients with breast cancer. Results Our simulation study shows that the relative bias of the factors, which the linking probability depends on, reaches the threshold of 20%, and is never less than 5%. The bias observed in the simulation for a comparable scenario is consistent with the actual one estimated from the breast cancer records. Conclusions Incomplete RL is rarely explicitly taken into account in the models for survival analysis. This study indicates that such a practice is potentially leading to inefficient and biased results, in particular in presence of medium or small sample sizes. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Non-fatal road casualties are under-reported, with official figures coming from the police. In the French Rhône county, a road trauma registry constitutes a second source of reporting but its completeness needs to be assessed. We also wish to estimate an incidence rate of non-fatal road casualties that is corrected for under-count. Methods: Having two sources of reporting available, we can apply the capture–recapture method under certain conditions. To take into account different reporting probabilities among casualties, the capture–recapture analysis is stratified according to injury severity (New Injury Severity Score=NISS), road user type and human third party. To evaluate the sensitivity of the capture–recapture estimate on the number of matched casualties between the police file and the registry, three scenarios of record-linkage are considered. Results: For serious (NISS 9+) non-fatal road casualties, the police ascertainment rate is at most 57%, the registry ascertainment rate is at most 87%, and the aggregate ascertainment rate is at most 95%. The ascertainment-corrected incidence rate for serious (NISS 9+) non-fatal road casualties is at least 65 per 100,000. Conclusion: The degree of completeness of the registry for serious casualties is rather high, though not satisfactory. [Copyright &y& Elsevier]

Record-linkage refers to the linking together of data relating to the same individual from separate source files. In this paper, we discuss ways in which the technique can enhance observational prescribing research in large populations. We draw upon the work of the Medicines Monitoring Unit (MEMO), University of Dundee, to illustrate its contribution to prescribing research. [ABSTRACT FROM AUTHOR]

Objective: To estimate the completeness of the French mandatory AIDS surveillance system (Declaration Obligatoire DO) over the 1990-1993 period using a capture-recapture approach, by matching the mandatory reports with the AIDS cases present in the French Hospital Database on HIV infection (FHDH).Methods: An anonymous record-linkage algorithm was developed to identify those cases common to both anonymous surveillance systems. The linkage was based on sex, date of birth, and infection risk group, all strictly matched, and on the dates of AIDS diagnosis and of death, the places of diagnosis and residence, and the AIDS-defining diseases at diagnosis. The total number of AIDS cases and completeness of both surveillance systems were estimated using a capture-recapture approach, assuming independence of the ascertainment sources.Results: The completeness of the mandatory reporting was estimated at 83.6% (95% CI: 82.9-84.3), and that of the FHDH at 47.6% (95% CI: 46.9-48.3) for the surveillance of AIDS cases diagnosed among adults in France between 1990 and 1993. The completeness of the system based on FHDH increased over the study period as more hospitals joined the project, while the completeness of the DO surveillance system remained stable.Conclusion: This approach was useful in estimating the underreporting of AIDS cases in France. Regularly performed, it will allow the impact of underreporting to be monitored over time. [ABSTRACT FROM AUTHOR]