Luk Arbuckle1, Ester Moher1, Susan J Bartlett2, Sara Ahmed3, Khaled El Emam4. 1. Electronic Health Information Laboratory, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, Canada K1H 8L1. 2. Department of Medicine, McGill University/McGill University Health Center, 687 Pine Ave W R4.29, Montreal, Quebec, Canada H3A 1A1; Division of Rheumatology, Johns Hopkins School of Medicine, 5200 Eastern Avenue #4100, Baltimore, MD 21224, USA. 3. School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montreal, Quebec, Canada H3G 1Y5; Department of Pediatrics, Faculty of Medicine, University of Ottawa, 401 Smyth Road, Ottawa, Canada K1H 8L1. 4. Electronic Health Information Laboratory, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, Canada K1H 8L1; Department of Pediatrics, Faculty of Medicine, University of Ottawa, 401 Smyth Road, Ottawa, Canada K1H 8L1. Electronic address: kelemam@ehealthinformation.ca.
Abstract
BACKGROUND: Patient-reported outcomes (PROs) are collected with consent for care; however, using the data for any other purpose requires consent for that additional purpose, or the anonymization of the data. Collecting explicit consent to use this data for secondary purposes, before the patient completes a PRO, can also bias the responses. OBJECTIVE: We consider the ethical and security issues related to the collection of data at the point of care or in the population and the aggregation and integration of PRO data with administrative databases to facilitate decision making and comparative effectiveness research. DISCUSSION: In this article, we describe risk-based anonymization, taking the context of the data release into account, so that we may consider the degree by which the release is considered anonymized. We also consider the ethical use of anonymized data, the anonymization of free-form text, and the secure linking data sets without sharing any personal information. Many good standards and best practices exist for the sharing of health data and could be used as a baseline in the development of a national PRO initiative.
BACKGROUND:Patient-reported outcomes (PROs) are collected with consent for care; however, using the data for any other purpose requires consent for that additional purpose, or the anonymization of the data. Collecting explicit consent to use this data for secondary purposes, before the patient completes a PRO, can also bias the responses. OBJECTIVE: We consider the ethical and security issues related to the collection of data at the point of care or in the population and the aggregation and integration of PRO data with administrative databases to facilitate decision making and comparative effectiveness research. DISCUSSION: In this article, we describe risk-based anonymization, taking the context of the data release into account, so that we may consider the degree by which the release is considered anonymized. We also consider the ethical use of anonymized data, the anonymization of free-form text, and the secure linking data sets without sharing any personal information. Many good standards and best practices exist for the sharing of health data and could be used as a baseline in the development of a national PRO initiative.