Abstract
BackgroundChronic hepatitis B (CHB) is endemic in the Aboriginal population of Australia’s Northern Territory (NT). However, many people’s hepatitis B virus (HBV) status remains unknown.Objective1. To maximise the utility of existing HBV test and vaccination data in the NT by creating a linked dataset and computerised algorithmic coding. 2. To undertake rigorous quality assurance processes to establish feasibility of using the linked dataset and computerised algorithmic coding for individual care for people living with CHB.MethodsStep 1: We used deterministic data linkage to merge information from three separate patient databases. HBV testing and vaccination data from 2008–2016 was linked and extracted for 19,314 people from 21 remote Aboriginal communities in the Top End of the NT. Step 2: A computerised algorithm was developed to allocate one of ten HBV codes to each individual. Step 3: A quality assurance process was undertaken by a clinician, using standardised processes, manually reviewing all three databases, for a subset of 5,293 Aboriginal people from five communities to check the accuracy of each allocated code.ResultsThe process of data linking individuals was highly accurate at 99.9%. The quality assurance process detected an overall error rate of 17.7% on the HBV code generated by the computerised algorithm. Errors occurred in source documentation, primarily from the historical upload of paper-based records to electronic health records. An overall HBV prevalence of 2.6% in five communities was found, which included ten cases of CHB who were previously unaware of infection and not engaged in care.ConclusionsData linkage of individuals was highly accurate. Data quality issues and poor sensitivity in the codes produced by the computerised algorithm were uncovered in the quality assurance process. By systematically, manually reviewing all available data we were able to allocate a HBV status to 91% of the study population.
Highlights
Chronic hepatitis B (CHB) infection is a serious public health challenge, with an estimated 292 million people living with CHB infection worldwide, and a global prevalence estimated at 3.9% [1]
The quality assurance process detected an overall error rate of 17.7% on the hepatitis B virus (HBV) code generated by the computerised algorithm
Errors occurred in source documentation, primarily from the historical upload of paper-based records to electronic health records
Summary
Chronic hepatitis B (CHB) infection is a serious public health challenge, with an estimated 292 million people living with CHB infection worldwide, and a global prevalence estimated at 3.9% [1]. A recent systematic review and meta-analysis showed an overall prevalence of 10.8% in pre and 3.5% in post-universal vaccination populations in Aboriginal and Torres Strait Islander people (hereafter respectfully referred to as Aboriginal) in Australia [3]. CHB is endemic in Aboriginal people of the Northern Territory (NT) of Australia, with a contemporary estimated prevalence of 6.1% [4]. In 1988, the NT was one of the first places in the world to introduce a universal newborn and infant hepatitis B virus (HBV) vaccination program for Aboriginal children, which expanded to include all children in the NT in 1990 [6, 7]. Chronic hepatitis B (CHB) is endemic in the Aboriginal population of Australia’s Northern Territory (NT). Many people’s hepatitis B virus (HBV) status remains unknown
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
