Algorithms to anonymize structured medical and healthcare data:A systematic review

Introduction: With many anonymization algorithms developed for structured medical health data (SMHD) in the last decade, our systematic review provides a comprehensive bird’s eye view of algorithms for SMHD anonymization. Methods: This systematic review was conducted according to the recommendations in the Cochrane Handbook for Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Eligible articles from the PubMed, ACM digital library, Medline, IEEE, Embase, Web of Science Collection, Scopus, ProQuest Dissertation, and Theses Global databases were identified through systematic searches. The following parameters were extracted from the eligible studies: author, year of publication, sample size, and relevant algorithms and/or software applied to anonymize SMHD, along with the summary of outcomes. Results: Among 1,804 initial hits, the present study considered 63 records including research articles, reviews, and books. Seventy five evaluated the anonymization of demographic data, 18 assessed diagnosis codes, and 3 assessed genomic data. One of the most common approaches was k-anonymity, which was utilized mainly for demographic data, often in combination with another algorithm; e.g., l-diversity. No approaches have yet been developed for protection against membership disclosure attacks on diagnosis codes. Conclusion: This study reviewed and categorized different anonymization approaches for MHD according to the anonymized data types (demographics, diagnosis codes, and genomic data). Further research is needed to develop more efficient algorithms for the anonymization of diagnosis codes and genomic data. The risk of reidentification can be minimized with adequate application of the addressed anonymization approaches. Systematic Review Registration: [http://www.crd.york.ac.uk/prospero], identifier [CRD42021228200].</p

Improvement of Erectile Dysfunction by Revascularization Surgery Following Urethroplasty in Patients with Pelvic Fracture

Introduction: Erectile dysfunction is one of the most common sexual disorders in men and affects one out of every five men over the age of 40 years. Penile revascularization is one of the methods for treating erectile dysfunction in these patients.Methods: The participants were patients who had erectile dysfunction after a pelvic fracture. These patients had Urethroplasty for at least one year ago due to urethral trauma and also undergone penile micro vascularization surgery. Sexual activity was allowed from the second month accompanied with the administration of tadalafil and yohimbine prior to intercourse.Results: In this study, 52 patients with the mean age of 30.65 ± 7 years (range: 24-45) were included. 24 patients (46%) were married. The mean time interval between pelvic fracture and surgery was 49.80 ± 16.30 months (range: 22 to 85). Complete response was seen in 9 cases (17.3%), relative responses in 18 (34.6%), and treatment failure in 25 cases (48.1%). The treatment results did not show any significant difference between the two dissimilar surgical procedures (Micheal versus-Virag) (P = 0.58).Conclusion: Based on this case-series, it is concluded that penile revascularization surgery seems to have a relatively good effect on the improvement of vascular erectile dysfunction in patients with pelvic fracture urethral distraction effect following Urethroplasty