Verbesserung des Record Linkage für die Gesundheitsforschung in Deutschland

Timm Intemann, Knut Kaulke, Dennis-Kenji Kipker, Vanessa Lettieri, Christoph Stallmann, Carsten O. Schmidt, Lars Geidel, Martin Bialke, Christopher Hampf, Dana Stahl, Martin Lablans, Florens Rohde, Martin Franke, Klaus Kraywinkel, Joachim Kieschke, Sebastian Bartholomäus, Anatol-Fiete Näher, Galina Tremper, Mohamed Lambarki, Stefanie March, Fabian Prasser, Anna Christine Haber, Johannes Drepper, Irene Schlünder, Toralf Kirsten, Iris Pigeot, Ulrich Sax, Benedikt Buchner, Wolfgang Ahrens, Sebastian C. Semler
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Abstract

Record linkage means linking data from multiple sources. This approach enables the answering of scientific questions that cannot be addressed using single data sources due to limited variables. The potential of linked data for health research is enormous, as it can enhance prevention, treatment, and population health policies. Due the sensitivity of health data, there are strict legal requirements to prevent potential misuse. However, these requirements also limit the use of health data for research, thereby hindering innovations in prevention and care. Also, comprehensive Record linkage in Germany is often challenging due to lacking unique personal identifiers or interoperable solutions. Rather, the need to protect data is often weighed against the importance of research aiming at healthcare enhancements: for instance, data protection officers may demand the informed consent of individual study participants for data linkage, even when this is not mandatory. Furthermore, legal frameworks may be interpreted differently on varying occasions. Given both, technical and legal challenges, record linkage for health research in Germany falls behind the standards of other European countries. To ensure successful record linkage, case-specific solutions must be developed, tested, and modified as necessary before implementation. This paper discusses limitations and possibilities of various data linkage approaches tailored to different use cases in compliance with the European General Data Protection Regulation. It further describes requirements for achieving a more research-friendly approach to linking health data records in Germany. Additionally, it provides recommendations to legislators. The objective of this work is to improve record linkage for health research in Germany.
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德国改进健康研究的记录链接
记录关联是指将多个来源的数据关联起来。这种方法可以回答由于变量有限而无法使用单一数据源解决的科学问题。链接数据在健康研究方面的潜力是巨大的,因为它可以加强预防、治疗和人口健康政策。由于健康数据的敏感性,有严格的法律要求来防止潜在的滥用。然而,这些要求也限制了健康数据在研究中的使用,从而阻碍了预防和护理方面的创新。此外,在德国,由于缺乏独特的个人标识符或可互操作的解决方案,全面的记录链接往往具有挑战性。相反,保护数据的必要性往往要与旨在提高医疗保健水平的研究的重要性相权衡:例如,数据保护官员可能会要求研究参与者在知情的情况下同意数据链接,即使这并非强制性的。此外,法律框架在不同的场合可能会有不同的解释。鉴于技术和法律两方面的挑战,德国健康研究的记录关联落后于其他欧洲国家的标准。为确保记录关联的成功,必须在实施前开发、测试并在必要时修改针对具体案例的解决方案。本文讨论了根据《欧洲通用数据保护条例》针对不同使用案例所定制的各种数据链接方法的局限性和可能性。此外,本文还向立法者提出了建议。这项工作的目标是改进德国健康研究的记录链接。
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