Personal Identification Code Research Articles

Recall and Recognition of User Codes: PIP versus PIN Personal Identification Code

Recall and Recognition of User Codes: PIP versus PIN Personal Identification Code

Measurement of social- and health outcomes in integrated settings

This document describes those actions which are the most important to measure the regional system and provide more “out – of – hospital” services as well as some social services. This is due the fact that during recent years we have seen a plethora of new management approaches for improving organizational performance. So far all these approaches in social and healthcare have only meant providing great volumes, measuring and prizing single products, supervising of contracts, controlling and calculating budgets and adding regulation. In spite of that the costs continue to rise at an unsustainable rate in all countries. Social- and healthcare organizations in different countries are focused on costs, not social and health outcomes and values. This calls for a new and more holistic measurement of health outcomes and wellbeing in society and also more understanding of digitalized services. To-day the systems reward those providers, public or private who shift costs and bill for more services, not those providers who deliver the most value. In the care chain the focus is on minimizing the cost for each piece of intervention and limiting services rather than on maximizing value over the entire care cycle. Moreover, without integrated organization structure and comprehensive outcome measurement, it is hard to know what improves value and what does not. The measurement is possible to implement especially in Finland and in South Karelia Social- and Healthcare District (EKSOTE) because every Finnish resident has a personal identity code. This means that the measuring system has unique personal identifiers to link multiple sources of data- such as episodes of care, visits to doctor or expert nurse, visits to emergency room services, labor input and compensation that currently exists in multiple databases. The possibility of linking the various data sets in this fashion has the potential for creating a holistic view of outcomes and system costs, both direct and indirect, across the entire care-delivery pathway. It is possible to investigate weather investing in preventive care in order to avoid higher treatment costs at later points in value chain. In practice this means for example to invest more in home rehabilitation to keep patients in good condition and then have less service needs in other parts of the pathway. The other example is to invest in a new kind of emergency care model to avoid patient transportation to emergency room services. Also following questions have answers: Do patients/customers come back to other services? Where are customers after certain period of time? What is the service utilization (and costs) of different customer groups and are there any changes? How the customer groups care/service pathways have gone (processes)? Aid in decision making: What are the options and what are the effects (to customer and costs) on longer term.

The pregnancy in neurofibromatosis 1: A retrospective register-based total population study.

The objective of this retrospective total population study was to form a view of the pregnancies of the patients with neurofibromatosis type 1 (NF1). A cohort of 1,410 Finnish patients with NF1 was acquired by searching NF1-related inpatient and outpatient hospital visits and confirming the diagnoses by reviewing the medical records. Ten matched control persons per patient with NF1 were collected from Population Register Centre. Study persons were linked to data from Medical Birth Register and Care Register for Health Care through the personal identity code. Cesarean deliveries, hypertension/preeclampsia, and placental abruptions were more common among mothers with NF1 with adjusted odds ratios of 2.24 (95%CI 1.63-3.07), 1.96 (95%CI 1.18-3.24), and 13.40 (95%CI 4.26-42.13), respectively. The adjusted mean pregnancy duration was 0.65 (95%CI 0.42-0.88) weeks shorter among the mothers with NF1 than in the control group consisting of non-NF1 mothers giving birth to a non-NF1 child. The pregnancies of non-NF1 mothers giving birth to a NF1 child were 0.43 (95%CI 0.24-0.62) weeks shorter than in the control group. In summary, NF1 of the mother was associated with a shortened pregnancy and increased pregnancy complications. Also, the NF1 of the fetus slightly shortened pregnancy. Since mothers with NF1 are at increased risk for pregnancy complications, careful evaluation of their pregnancies is warranted.

Establishing and maintaining the National Vaccination Register in Finland.

Computerised, population-based vaccination registers are valuable tools for assessing the vaccine uptake and impact in populations. However, reliable impact assessment is only possible if the data quality can be reviewed and monitored continuously. This report describes the establishment and maintenance of the National Vaccination Register (NVR) in Finland. Currently, the NVR covers nationwide records of vaccinations given within the frame of the National Vaccination Programme since 2009. All vaccinations registered in the NVR contain a record of the personal identity code, the administered vaccine, and the date of vaccination. The vaccine lot number is the key component for recording and identifying vaccinations, because of its broad availability across patient information systems and its importance in vaccine safety monitoring. Vaccination records are accumulated and updated daily into the NVR, and their completeness is monitored monthly to assess deficiencies in data entry and data collection. Additionally, an alert system reports unexpected changes in data accumulation prompting the validation of observed changes in vaccination coverage. The presented process documentation may serve as basis to improve the design and quality of other vaccination or healthcare registers and aims to inspire the set-up of vaccination registers in those countries which still do not have one.

Effectiveness of the live attenuated and the inactivated influenza vaccine in two-year-olds - a nationwide cohort study Finland, influenza season 2015/16.

Although widely recommended, influenza vaccination of children is part of the national vaccination programme only in few countries. In addition to Canada and the United States (US), in Europe Finland and the United Kingdom have introduced live attenuated influenza vaccine (LAIV) for healthy children in their programmes. On 22 June 2016, the US Advisory Committee on Immunizations Practices, voted against further use of LAIV due to no observed vaccine effectiveness (VE) over three consecutive influenza seasons (2013/14 to 2015/16). We summarise the results of a nationwide, register-based cohort study (N=55,258 of whom 8,086 received LAIV and 4,297 TIV); all outcome (laboratory-confirmed influenza), exposure (vaccination) and confounding variable data were retrieved from four computerised national health registers, which were linked via a unique personal identity code assigned to all permanent Finnish residents regardless of nationality. Our study provides evidence of moderate effectiveness against any laboratory-confirmed influenza of the quadrivalent LAIV vaccine (VE: 51%; 95% confidence interval (CI): 28–66%) as well as the inactivated trivalent vaccine (VE: 61%; 95% CI: 31–78%) among two-year-olds during the influenza season 2015/16 in Finland. Based on these data, Finland will continue using LAIV for young children in its National Immunisation Programme this coming influenza season.

The coverage of elective revascularisation procedure codes in the National Finnish Hospital Discharge Register

Introduction: Administrative registers provide an attractive data source for real-life effectiveness studies. The validity of coronary artery disease diagnoses in the Finnish National Hospital Discharge Register (HDR) is high but the validity of revascularization procedure codes (percutaneous coronary intervention; PCI and coronary artery bypass grafting; CABG) are unknown.Methods: All elective PCIs (n = 1771) and CABGs (n = 1819), performed at the Heart Center, Kuopio University Hospital, Finland between years 2007 and 2014 were identified from the unit’s Special Electronic Medical Records (sEMR). Personal identity codes were used to link these data to the HDR. Sensitivity was estimated as proportion of operations recorded in sEMR and HDR.Results: With the strictest assumption of exactly the same intervention day in HDR and sEMR, the sensitivity for procedure codes were 84.6% for PCI and 97.1% for CABG, respectively. When a one-day difference was allowed in the dates, the sensitivity increased to 87.6% for PCI and 98.0% for CABG. Altogether 62.1% of elective PCIs and 69.2% of CABGs were correctly classified as elective procedures in the HDR.Conclusion: The potential of the research application of the HDR extends beyond traditionally used diagnostic codes. One feasible application is the assessment of real-life effectiveness of different procedures.KEY MESSAGESThe majority of PCIs (87.6%) and CABGs (98.0%), performed in the Heart Center, Kuopio University Hospital responsible for the treatment of approximately one fifth of the Finnish population, were captured by the Finnish National Hospital Discharge Register.However, only 62.1% of elective PCIs and 69.2% of CABGs were correctly classified as elective procedures in the HDR. Electivity data were missing from approximately one third of the procedures.This study produces new information of the potential use of HDR for real-life effectiveness studies to support evidence-based decision making in health care.

Antidepressant use and violent crimes among young people: a longitudinal examination of the Finnish 1987 birth cohort

BackgroundThe use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), has been questioned due to poor efficacy and safety. We examined whether young violent offenders were more likely antidepressant users...

The use of COPD maintenance therapy following spirometry in General Practice

BackgroundSeveral studies have shown that the use of pulmonary medication is widespread and often initiated without initial spirometry. Early detection of chronic obstructive pulmonary disease (COPD) by spirometry in General Practice is essential for an early and correct implementation of medical treatment.AimThe aim of the present study was to evaluate the use of regular therapy following diagnostic spirometry for COPD in General Practice from February 2008 to February 2009.MethodSpirometry data and results were linked through Statistics Denmark with information from the Register of Medicinal Product Statistics using the unique personal identification code. Data were analysed to evaluate the impact of screening on use of regular COPD therapy. Primary outcome was initiation of regular therapy following COPD diagnosis with spirometry.ResultsIn a population of 3,376 individuals at risk, 1,458 underwent spirometric assessment with 631 being diagnosed with COPD; 110 of those received regular therapy before assessment with this figure increasing to 161 after spirometry. Of 827 participants not receiving a COPD diagnosis, 36 received regular therapy prior to assessment and 42 received regular therapy after spirometry despite no established COPD diagnosis.ConclusionThere is a significant chance of receiving regular therapy after being diagnosed with COPD. However, a large proportion of subjects diagnosed with COPD did not receive regular therapy following diagnosis. Efforts should be made to ensure correct diagnosis and correct medical treatment according to guidelines in individuals with COPD.

Incidence, morbidity, mortality, and prevalence of diabetes in Denmark, 2000-2011: results from the Diabetes Impact Study 2013.

PurposeAs part of the Danish Diabetes Impact Study 2013, we present trends in the incidence, morbidity, mortality, and prevalence of diabetes in Denmark for the period 2000 through 2011.Patients and methodsThe Danish National Diabetes Register was established in 2006 and is assumed to cover all patients with diabetes, alive as of the end of 1996, and all subsequent new cases. The present study is based on the content of the register as of July 3, 2013 (n=497,232 patients). Using the personal identification code assigned to all Danish inhabitants, all available supplementary information from the Danish National Patient Register and the Danish Civil Registration Service was used to define the date of diagnosis of diabetes and the first date of experiencing complications (grouped according to impact and severity).ResultsDuring the period of 2000 to 2011, the incidence rate of diabetes increased approximately 5% annually. During the same period, decreasing trends were observed for both the rates of progression in complications and of the complication-specific mortality. During the same period, the prevalence of diabetes doubled.ConclusionThe increasing prevalence of diabetes in Denmark is driven by increasing incidence combined with decreasing morbidity and mortality in the population of patients with diabetes. These mechanisms will be explored further as part of the Diabetes Impact Study 2013, together with investigations into the socioeconomic and health economic aspects of diabetes.

Metabolic serum biomarkers for the prediction of cancer: a follow-up of the studies conducted in the Swedish AMORIS study.

The Swedish Apolipoprotein MOrtality RISk study (AMORIS) contains information on more than 500 biomarkers collected from 397,443 men and 414,630 women from the greater Stockholm area during the period 1985–1996. Using a ten-digit personal identification code, this database has been linked to Swedish national registries, which provide data on socioeconomic status, vital status, cancer diagnosis, comorbidity, and emigration. Within AMORIS, 18 studies assessing risk of overall and site-specific cancers have been published, utilising a range of serum markers representing glucose and lipid metabolism, immune system, iron metabolism, liver metabolism, and bone metabolism. This review briefly summarises these findings in relation to more recently published studies and provides an overview of where we are today and the challenges of observational studies when studying cancer risk prediction.Overall, more recent observational studies supported previous findings obtained in AMORIS, although no new results have been reported for serum fructosamine and inorganic phosphate with respect to cancer risk. A drawback of using serum markers in predicting cancer risk is the potential fluctuations following other pathological conditions, resulting in non-specificity and imprecision of associations observed. Utilisation of multiple combination markers may provide more specificity, as well as give us repeated instead of single measurements. Associations with other diseases may also necessitate further analytical strategies addressing effects of serum markers on competing events in addition to cancer. Finally, delineating the role of serum metabolic markers may generate valuable information to complement emerging clinical studies on preventive effects of drugs and supplements targeting metabolic disorders against cancer.

Proposing national identification number on dental prostheses as universal personal identification code - A revolution in forensic odontology.

The proper identification of a decedent is not only important for humanitarian and emotional reasons, but also for legal and administrative purposes. During the reconstructive identification process, all necessary information is gathered from the unknown body of the victim and hence that an objective reconstructed profile can be established. Denture marking systems are being used in various situations, and a number of direct and indirect methods are reported. We propose that national identification numbers be incorporated in all removable and fixed prostheses, so as to adopt a single and definitive universal personal identification code with the aim of achieving a uniform, standardized, easy, and fast identification method worldwide for forensic identification.

Cancer incidence among Finnish ferrochromium and stainless steel production workers in 1967–2011: a cohort study

ObjectivesThe aim of the study was to assess the risk of cancer among workers employed in the Finnish ferrochromium and stainless steel industry since the beginning of production in 1967.MethodsThe...

248 Occupational exposure to trichloroethylene and perchloroethylene and the risk of lymphoma, liver and kidney cancer in four nordic countries

ObjectivesTrichloroethylene (TCE) and Perchloroethylene (PER) are two chlorinated solvents that have been applied widely as degreaser of metal parts and in dry cleaning and other applications. In 2012 the International...

279 Cholangiocarcinoma among workers in the printing industry: Using the Nordic Occupational Cancer database to elucidate a cluster report from Japan

ObjectivesA cluster of 11 cases of cholangiocarcinoma (CC) was recently observed in a small Japanese printing firm. To explore whether the identified cluster is indicative for an elevated risk of...

Cholangiocarcinoma among workers in the printing industry: using the NOCCA database to elucidate the generalisability of a cluster report from Japan

ObjectivesA cluster of 11 cases of cholangiocarcinoma (CC) was observed in a small Japanese printing firm. To elucidate whether the identified cluster is indicative of an elevated risk of CC...

Finnish Prenatal Study of Bipolar Disorders (FIPS-B): Overview, design and description of the sample

Background: Bipolar disorders (BPD) are chronic mental illnesses, the development of which involves genetic factors and environmental influences. Aims: The aim of this paper is to provide an overall description of the Finnish Prenatal Study of Bipolar Disorders (FIPS-B), including the study design, national registers and linkage of the registers. Methods: FIPS-B is a population-based prenatal epidemiological study of BPD with a nested case–control study design using several national registers. The registers used are: the Finnish Medical Birth Register (FMBR), the Finnish Hospital Discharge Register (FHDR), the Population Central Register and the Finnish Maternity Cohort (FMC), which are linked using the unique personal identity code (PIC). FIPS-B includes all children born from January 1, 1983 to December 31, 1998 and diagnosed with BPD in Finland by December 31, 2008. Results: The total number of cases included in the FIPS-B is 1887. The age at first diagnosis ranged from 4 to 25 years. Half (50.4%) of the cases utilized only outpatient services, 12.7% only inpatient services and the rest (36.9%) utilized both services. Offspring of mothers with the lowest educational level had an increased odds of BPD (OR = 1.46, 95% CI 1.13–1.88). The cumulative incidence of BPD in the population aged 25 years or younger was 11.6/10,000 in 2008. Conclusions: FIPS-B has all the strengths of a register-based prenatal epidemiological study, along with the availability of maternal biomarkers, enabling it to examine several prenatal, perinatal and familial risk factors for BPD.

Occupational exposure to trichloroethylene and perchloroethylene and the risk of lymphoma, liver, and kidney cancer in four Nordic countries

ObjectivesTrichloroethylene (TCE) and Perchloroethylene (PER) are two chlorinated solvents that are applied widely as degreasers of metal parts, and in dry cleaning and other applications. In 2012, the International Agency...

DANBIO--powerful research database and electronic patient record

The nationwide DANBIO registry has been designed to capture operational clinical data as part of routine clinical care. At the same time, it provides a powerful research database. This article reviews the DANBIO registry with focus on problems and solutions of design, funding and linkage, provides an overview of the research outcome and presents the cohorts of RA patients. The registry, which is approved as a national quality registry, includes patients with RA, PsA and AS, who are followed longitudinally. Data are captured electronically from the source (patients and health personnel). The IT platform is based on open-source software. Via a unique personal identification code, linkage with various national registers is possible for research purposes. Since the year 2000, more than 10,000 patients have been included. The main focus of research has been on treatment efficacy and drug survival. Compared with RA patients, who were on conventional treatment with DMARDs, the patients who started biological treatment were younger, had longer disease duration, higher disease activity, tried more DMARDs and received more prednisolone. Also, more patients on biological therapy were seropositive and had erosive disease. However, the current levels of disease activities and the fraction of patients who had gone into remission in the two groups of patients were very similar. This indicates that clinicians have a common treatment goal for RA patients regardless of treatment. In conclusion, DANBIO serves as an electronic patient 'chronicle' in routine care, and at the same time provides a powerful research database.

Alcohol consumption and higher incidence of impaired fasting glucose or type 2 diabetes in obese Korean men

It is inconclusive whether moderate alcohol consumption reduces the diabetes risk. We observed the development of impaired fasting glucose or type 2 diabetes according to the amount of alcohol intake and body mass index. The annual health evaluation data of 2,500 male workers from 2002 to 2006 were reviewed retrospectively deleting personal identification code. The information contained sex, age, medical history, smoking status, alcohol consumption, participating regular exercise, anthropometric, and biochemistry measurement. Impaired fasting glucose or diabetes was determined when fasting plasma glucose was ≥100 mg/dL. Thousand seven hundred seven subjects were eligible after excluding medical history of diabetes or fasting glucose ≥100 mg/dL at baseline. The relative risks of its development in group of taking 1–14, 15–29, and ≥30.0 g ethanol were 0.842 (95% confidence interval [CI], 0.603–1.176), 1.068 (95% CI, 0.736–1.551), and 1.019 (95% CI, 0.662–1.568) within normal weight group, 1.164 (95% CI, 0.795–1.705), 1.421 (95% CI, 0.947–2.133), and 1.604 (95% CI, 1.031–2.495) within overweight group, and 1.498 (95% CI, 1.042–2.153), 1.634 (95% CI, 1.091–2.447), and 1.563 (95% CI, 1.019–2.396) within obese group each after adjusting age, family history of diabetes, smoking, exercise, serum fasting glucose, aspartate aminotransferase, and γ-glutamyltransferase with nondrinkers as a reference group. Not only high alcohol consumption but also moderate drinking was related with higher incidence of impaired fasting glucose or diabetes in obese Korean men.

IVF treatment instructions transmitted via the internet: a preliminary experience

OBJECTIVE: IVF treatments are ambulatory but intensive and complicated. In our unit, most hormone therapy is administered by the patients themselves or by medical personnel outside of the IVF team, according to directions given to the patient. This communication is usually based on telephone orders, sometimes reinforced by facsimile. In a busy IVF unit, this method requires intensive labor, and is potentially inconvenient for the patient. Moreover, there is a possible risk of misinterpretation. In a preliminary survey, we found that difficulties in telephone-communication such as waiting time have become a major reason for dissatisfaction in our patients. By contrast, the Internet is readily accessible for 70% of our patients. Therefore, we developed an internet-based system for daily transfer of treatment orders during IVF treatments, on which we first report here. DESIGN: A description of an internet-based patient communication software MATERIALS AND METHODS: The Shaare Zedek Medical Centre medical informatics centre developed a novel system which enables IVF patients to receive personalized medical instructions using the internet. Based on clinical, laboratory and ultrasound results performed in the morning, instructions for further treatment are entered into the system by noon. Using a personal identification code, the patient is able to access the unit's internet site and access her orders. RESULTS: Within a few months following implementation of the system, nearly 40% of patients are using it routinely. We observe that our patients and team appear to be highly satisfied with the convenience and simplicity this approach offers. CONCLUSIONS: This is one of the first reports of individualized, internet-communicated IVF treatment protocols. According to our preliminary experience, this approach is not only feasible, but also efficient and user-friendly, being convenient for both patients and personnel. Moreover, it provides a reliable record and may reduce the risk of treatment errors.