A Protocol for the Secure Linking of Registries for HPV Surveillance

In order to monitor the effectiveness of HPV vaccination in Canada the linkage of multiple data registries may be required. These registries may not always be managed by the same organization and, furthermore, privacy legislation or practices may restrict any data linkages of records that can actually be done among registries. The objective of this study was to develop a secure protocol for linking data from different registries and to allow on-going monitoring of HPV vaccine effectiveness.A secure linking protocol, using commutative hash functions and secure multi-party computation techniques was developed. This protocol allows for the exact matching of records among registries and the computation of statistics on the linked data while meeting five practical requirements to ensure patient confidentiality and privacy. The statistics considered were: odds ratio and its confidence interval, chi-square test, and relative risk and its confidence interval. Additional statistics on contingency tables, such as other measures of association, can be added using the same principles presented. The computation time performance of this protocol was evaluated.The protocol has acceptable computation time and scales linearly with the size of the data set and the size of the contingency table. The worse case computation time for up to 100,000 patients returned by each query and a 16 cell contingency table is less than 4 hours for basic statistics, and the best case is under 3 hours.A computationally practical protocol for the secure linking of data from multiple registries has been demonstrated in the context of HPV vaccine initiative impact assessment. The basic protocol can be generalized to the surveillance of other conditions, diseases, or vaccination programs

Space Construction Experiment Definition Study (SCEDS), part 1. Volume 1: Executive summary

Definition was completed on a basic flight experiment which will provide data on the construction of large space systems from the orbiter which could not be practicably obtained from ground tests. Dynamic behavior of a representative large structure was predicted. On-orbit construction operations were studied. Orbiter control during and after construction was investigated. Evolutionary or supplemental flight experiments for the development of augmentation of a basic flight experiment were identified and defined

Accuracy and feasibility of an android-based digital assessment tool for post stroke visual disorders - The StrokeVision App

Background: Visual impairment affects up to 70% of stroke survivors. We designed an app (StrokeVision) to facilitate screening for common post stroke visual issues (acuity, visual fields and visual inattention). We sought to describe the test-time, feasibility, acceptability and accuracy of our app based digital visual assessments against a) current methods used for bedside screening, and b) gold standard measures. Methods: Patients were prospectively recruited from acute stroke settings. Index tests were app based assessments of fields and inattention performed by a trained researcher. We compared against usual clinical screening practice of visual fields to confrontation including inattention assessment (simultaneous stimuli). We also compared app to gold standard assessments of formal kinetic perimetry (Goldman or Octopus Visual Field Assessment); and pencil and paper based tests of inattention (Albert’s, Star Cancellation, and Line Bisection). Results of inattention and field tests were adjudicated by a specialist Neuro-Ophthalmologist. All assessors were masked to each other’s results. Participants and assessors graded acceptability using a bespoke scale that ranged from 0 (completely unacceptable) to 10 (perfect acceptability). Results: Of 48 stroke survivors recruited, the complete battery of index and reference tests for fields was successfully completed in 45. Similar acceptability scores were observed for app-based (assessor median score 10 [IQR:9-10]; patient 9 [IQR:8-10]) and traditional bedside testing (assessor 10 [IQR:9-10; patient 10 [IQR:9-10]). Median test time was longer for app-based testing (combined time-to-completion of all digital tests 420 seconds [IQR:390-588]) when compared with conventional bedside testing (70 seconds, [IQR:40-70]) but shorter than gold standard testing (1260 seconds, [IQR:1005-1620]). Compared with gold standard assessments, usual screening practice demonstrated 79% sensitivity and 82% specificity for detection of a stroke-related field defect. This compares with 79% sensitivity and 88% specificity for StrokeVision digital assessment. Conclusion: StrokeVision shows promise as a screening tool for visual complications in the acute phase of stroke. The app is at least as good as usual screening and offers other functionality that may make it attractive for use in acute stroke