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Second-Order Integrated Developmental Database
Systems: EHDI Applications
Craig A. Mason, Ph.D. Shihfen Tu, Ph.D.University of Maine
Centers for Disease Control and Prevention Second Annual National Early Hearing Detection and Intervention Conference, Atlanta, Georgia,
February, 2003.
Background
University of Maine research team involved in informatics research and development
Collaborations with colleagues in Florida at the University of Miami focusing on Developmental Epidemiology
Contact Information Craig A. Mason: [email protected] Shihfen Tu: [email protected]
Overview
Focus on application of strategies for enhancing the potential for public policy and public health research using EHDI data
Address future directions in which we see field heading Strategies we have and are developing for addressing
challenges posed
Second-Order Integrated Developmental Database Data for individuals integrated across multiple sources Data from related individuals is further coordinated, allowing
a higher order of organization Data for same factors obtained across multiple time points
Data Organization
Second-Order Integrated Developmental Database Structure data so that it can be automatically
organized on higher levels, such as family units Recognize the fluid nature of family organizations
Maintain historical or developmental data in readily accessible format
Maintain potential to operate as a functioning administrative database
Example from Child LINK
Complex Blended Family
First-Order Integrated Data Data from multiple sources available and summarized
Basis of flag for hearing reflects referral for left ear
Similar information available regarding birth defects
Second-Order Integrated Data Data from related individuals connected (e.g., family)
All information on related individuals readily accessible through active links
Public health officials able to instantaneously identify and move across multiple members of an extended, blended family
Assist in identifying at-risk individuals
Identify patterns of disorders
Basis for flag under birth defects reflects spina bifida and cleft lip/palate
Second-Order Integrated Developmental Database
Developmental database maintain full history of all individuals
Multiple tests, assessments, events are all maintained and accessible for all individuals across all time ranges
Examine past and future changes in parent education, marital status, home addresses, etc. For example, parents education is obtained from
every birth record, stored electronically, and accessible over time
Jan’s records only indicate that her mother completed 11 years of school
Second-order developmental data shows she went on to complete college
Similar issues when examining broad range of environmental factors
Jan’s records only indicate the family lived in Caribou, Maine
Second-order developmental data shows how family moved over time
Enhances ability to explore environmental factors
Summary
Second-Order Integrated Developmental Database Link an individual’s health data across multiple sources Connects data from relevant, related individuals Maintains all information over time
Benefits Enhanced ability to identifying and track Prevention of “lost cases” Allow longitudinal epidemiological research on family
factors (genetic/environmental) at a population level
Summary
Challenges Can require rapidly increasing number of tables Can require multiple “unique” identifiers for each
individual Can result in exponentially compounded errors Can be difficult to evaluate quality of linkage
