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The public-use National Health Interview Survey linked mortality files: methods of reidentification risk avoidance and comparative analysis.

ABSTRACT: The National Center for Health Statistics (NCHS) conducts mortality follow-up for its major population-based surveys. In 2004, NCHS updated the mortality follow-up for the 1986-2000 National Health Interview Survey (NHIS) years, which because of confidentiality protections was made available only through the NCHS Research Data Center. In 2007, NCHS released a public-use version of the NHIS Linked Mortality Files that includes a limited amount of perturbed information for decedents. The modification of the public-use version included conducting a reidentification risk scenario to determine records at risk for reidentification and then imputing values for either date or cause of death for a select sample of records. To demonstrate the comparability between the public-use and restricted-use versions of the linked mortality files, the authors estimated relative hazards for all-cause and cause-specific mortality risk using a Cox proportional hazards model. The pooled 1986-2000 NHIS Linked Mortality Files contain 1,576,171 records and 120,765 deaths. The sample for the comparative analyses included 897,232 records and 114,264 deaths. The comparative analyses show that the two data files yield very similar results for both all-cause and cause-specific mortality. Analytical considerations when examining cause-specific analyses of numerically small demographic subgroups are addressed.

SUBMITTER: Lochner K

PROVIDER: S-EPMC2727263 | biostudies-literature | 2008 Aug

REPOSITORIES: biostudies-literature

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The public-use National Health Interview Survey linked mortality files: methods of reidentification risk avoidance and comparative analysis.

Lochner Kimberly K Hummer Robert A RA Bartee Stephanie S Wheatcroft Gloria G Cox Christine C

American journal of epidemiology 20080523 3

The National Center for Health Statistics (NCHS) conducts mortality follow-up for its major population-based surveys. In 2004, NCHS updated the mortality follow-up for the 1986-2000 National Health Interview Survey (NHIS) years, which because of confidentiality protections was made available only through the NCHS Research Data Center. In 2007, NCHS released a public-use version of the NHIS Linked Mortality Files that includes a limited amount of perturbed information for decedents. The modificat ...[more]

PMID: 18503037

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Project description:BackgroundLife expectancy is increasingly incorporated in evidence-based screening and treatment guidelines to facilitate patient-centered clinical decision-making. However, life expectancy estimates from standard life tables do not account for health status, an important prognostic factor for premature death. This study aims to address this research gap and develop life tables incorporating the health status of adults in the United States.MethodsData from the National Health Interview Survey (1986-2004) linked to mortality follow-up through to 2006 (age ≥ 40, n = 729,531) were used to develop life tables. The impact of self-rated health (excellent, very good, good, fair, poor) on survival was quantified in 5-year age groups, incorporating complex survey design and weights. Life expectancies were estimated by extrapolating the modeled survival probabilities.ResultsLife expectancies incorporating health status differed substantially from standard US life tables and by health status. Poor self-rated health more significantly affected the survival of younger compared to older individuals, resulting in substantial decreases in life expectancy. At age 40 years, hazards of dying for white men who reported poor vs. excellent health was 8.5 (95% CI: 7.0,10.3) times greater, resulting in a 23-year difference in life expectancy (poor vs. excellent: 22 vs. 45), while at age 80 years, the hazards ratio was 2.4 (95% CI: 2.1, 2.8) and life expectancy difference was 5 years (5 vs. 10). Relative to the US general population, life expectancies of adults (age < 65) with poor health were approximately 5-15 years shorter.ConclusionsConsiderable shortage in life expectancy due to poor self-rated health existed. The life table developed can be helpful by including a patient perspective on their health and be used in conjunction with other predictive models in clinical decision making, particularly for younger adults in poor health, for whom life tables including comorbid conditions are limited.

Project description:BackgroundDespite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions.MethodsWe conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions.FindingsOur sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13%) of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28%) of men who reported having prostate cancer screening, and 10% (95% CI 6%-15%) of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95%) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82%) felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100%) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity.ConclusionsA small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies to better inform people about overdiagnosis, and review disease definition processes, have significant public sympathy.

Dataset Information

The public-use National Health Interview Survey linked mortality files: methods of reidentification risk avoidance and comparative analysis.

Publications

The public-use National Health Interview Survey linked mortality files: methods of reidentification risk avoidance and comparative analysis.

Similar Datasets

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