Regional Disparities in Incidence, Handling and Outcomes of Patients with Symptomatic and Ruptured Abdominal Aortic Aneurysms in Norway

Objectives: To study incidence, handling and outcome of patients hospitalised with symptomatic and ruptured abdominal aortic aneurysm in Norway. Design, material and methods: Retrospective study of 1291 patients, between January 2008 and August 2010 using the National Patient Registry and a regional vascular surgery registry. We applied a stepwise logistic regression model to detect differences in regional in-hospital mortality. Results: 385/711 (54%) patients hospitalised for aneurysm rupture, rAAA (ICD-10:171.3), died. The odds of dying varied with a factor 2.3 between the extreme regions. 475/711 (67%) underwent repair, 323 survived, giving an in-hospital mortality rate of 32% after surgery. Older patients were significantly less likely to be transported for surgery. The overall incidence for patients aged >50 was 16.6 rAAA per 100 000 person-years. There was remarkable variation across counties with rates between 7. Conclusions: For rAAA, we found substantial geographical variations in incidence, surgery and patient outcome. These results highlight the need for increased awareness about the condition and suggest ways to improve care trajectories to reduce delay to surgery, thereby minimising rupture mortality. (C) 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Abstract Anonymization of General Practioner Medical Records

The Electronic Patient Record (EPR) is both a legal document and a tool for use by physicians and other health personnel during provision of health care. Its primary purpose is to provide and store information about the patient in clinical settings, but it’s also a source of medical knowledge (e.g. epidemiology and quality of care). Due to the sensitive nature of the data they must be handled in a secure manner with a high awareness of privacy concerns. This problem can be partially avoided by applying an anonymization procedure to the data. For large volumes of data (e.g. thousands of patient records) such a procedure must be partially automated. We aim to develop techniques and methods for semi-automated anonymization of medical record information. We first present the requirements and goals of anonymization. Relevant goals for designing an anonymization method are: complying with national laws, and making the anonymization as automated as possible. We discuss anonymization challenges, including linguistic issues (e.g. spelling and ambiguity) and determining which parts of the data that is sensitive. Finally we propose methods including utilization of database structure, dictionaries, heuristics and natural language processing for anonymizing patient records in general, but with focus on general practioner records gathered from a Profdoc Vision database

User Experiences and Satisfaction with an Electronic Health Record System

Author's accepted manuscript (postprint).acceptedVersio