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'Soundex' codes of surnames provide confidentiality and accuracy in a national HIV database.

Clinicians and microbiologists will participate in voluntary national reporting of HIV infections and AIDS only if they have confidence in the scheme's confidentiality. At the same time, if the data are to be accurate, it must be possible to recognise reports that refer to the same individual. The use of surname 'soundex' code in combination with date of birth meets both requirements. We describe its use in the database of reported HIV infections held at the PHLS AIDS Centre. By the end of 1994 over 93% of the 20,407 reports on the database were soundex coded, and 70% of AIDS reports were linked to independent reports of HIV infection from microbiologists. In 1994, 22% of the reports of HIV infection were recognised as duplicating earlier reports of infection. Coding surnames using soundex is an acceptable and practical tool in surveillance of an infection for which confidentiality is a prime concern.

Acquired Immunodeficiency Syndrome↗

AIDS and the Soundex code.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

Mechanization of library procedures in the medium-sized medical library. X. Uniqueness of compression codes for bibliographic retrieval.

Two-word compression techniques, the University of Chicago experimental search code and a phonetic code similar to the SOUNDEX coding system, were tested as search codes on a data base of 7,464 bibliographic records. These codes were automatically generated and tested for uniqueness. A modified version of the University of Chicago search code produced the best results with a uniqueness factor of 98.83 percent. The algorithms for generating these codes are explained, and implication of the findings for medium-sized libraries are discussed.

Bibliographies as Topic↗

A two-stage alphabetic to client number cross-reference system.

A two-stage process for cross-referencing name to number is described. The first stage computes a near-uniform data-base page address based on a modified Russell-Soundex code. Records located at this page address are then passed against a best-match algorithm in the second phase and match candidates displayed to the user. Two years of use and a doubling of record entries has been possible without a reorganization of the data-base file.

Ambulatory Care Facilities↗

Mortality from overdose among injecting drug users recently released from prison: database linkage study.

OBJECTIVE: To assess whether injecting drug users have a higher than usual risk of death from overdose in the 2 weeks after release from prison. DESIGN: Soundex coding of surnames and information on date of birth were used to link entry and release dates from the local prison between 1983 and 1994 with clinical data from Edinburgh City Hospital's cohort of male injecting drug users who are infected with HIV. SETTING: Edinburgh City Hospital and Edinburgh Prison. SUBJECTS: 316/332 male injecting drug users infected with HIV in the City Hospital HIV cohort; 16 were excluded because they were enrolled after developing AIDS or because their precise date of death was not available. MAIN OUTCOME MEASURE: Relative risk of dying from overdose before developing AIDS and relative risk of dying of all causes before developing AIDS during the 2 weeks after release from prison; this was compared with relative risks of death during other time at liberty. RESULTS: 238/316 (75%) injecting drug users served time in the prison between 1983 and 1994. 33 out of 316 injecting drug users who were infected with HIV died before developing AIDS during 517,177 days at risk. 20 of these men died of an overdose; 6 of these deaths occurred within 2 weeks of release during 5903 days at risk. Death rates from overdose before the development of AIDS were 1.02/1000 days during the 2 weeks after release (recently released) and 0.029/1000 days during other times of liberty. The relative risk of death from overdose became 7.7 (1.5 to 39.1) after temporal matching (when the comparison was limited to the first 2 weeks after release v the next 10 weeks). The crude relative risk in an analysis combining stratified prison term and the 2 weeks after release was 4.5 (1.7 to 11.7) for death from overdose. After temporal matching these risks became 1.8 (0.4 to 9.2). CONCLUSION: Prisons should evaluate interventions to reduce the risk of death from overdose after release.

Acquired Immunodeficiency Syndrome↗

Undernotification of tuberculosis in patients with AIDS.

The purpose of this study was to establish the extent of undernotification of tuberculosis in AIDS patients resident in 2 inner London local authorities. For residents of the 2 authorities, statutory notifications of tuberculosis between 1986 and 1992 were compared, using soundex codes of surnames, sex and year of birth, with AIDS cases reported to the Public Health Laboratory Service (PHLS) AIDS Centre during the same period where TB had been recorded on the AIDS report form. In 36 of 613 AIDS cases reported as residents of the 2 authorities tuberculosis was recorded on the AIDS report form. Matching revealed that only 2 (6%) of these cases had been notified to the local authority. These results highlight the need to resolve the dilemma between concerns about patient confidentiality and the statutory requirement to notify tuberculosis so that clinical management of contacts can be undertaken and the true impact of HIV infection on the incidence of tuberculosis in the UK can be elucidated.

AIDS-Related Opportunistic Infections↗

HIV-related malignancies: community-based study using linkage of cancer registry and HIV registry data.

For people immunosuppressed by human immunodeficiency virus (HIV), we expect an increase in cancer incidence similar to that documented in transplant patients. We examined the cancer spectrum in an HIV-infected cohort, specifically malignancies not currently associated with acquired immunodeficiency syndrome (AIDS), in relation to the general population. Cancer incidence data for residents of Harris County, Texas, diagnosed between 1975 and 1994, were linked to HIV/AIDS registry data by Soundex code and date of birth to identify malignancies in an HIV-infected cohort of 14,986 persons. Incidence of cancer in this cohort was compared to the general population by standardized incidence ratio (SIR) analysis. From the HIV-infected cohort, 2289 persons (15%) were identified as having one or more malignancies, with 97% occurring in males. The linkage alone identified 29.5% of the malignancies, of which only 28.7% were diagnosed in males. Adjusting for age, HIV-infected men and women had incidences of cancer that were 16.7 [95% confidence interval (CI) 16.1-17.3] and 2.9 (95% CI 2.3-3.7) times that expected for the general population of Harris County, Texas. Besides Kaposi's sarcoma, non-Hodgkin's lymphoma, cervix cancer and brain lymphoma, non-AIDS related malignancies of Hodgkin's lymphoma, non-melanotic skin cancer in males and colon cancer in females, exhibited significant SIRs of 5.6 (95% CI 3.6-8.4), 6.9 (95% CI 4.8-9.5) and 4.0 (95% CI 1.1-10.2). Increased incidences of lung, prostate and breast malignancies were not seen in this HIV cohort. Persons infected with HIV appear to be at increased risk for the non-AIDS related malignancies, Hodgkin's lymphoma, non-melanotic skin cancer in males and colon cancer in females.

Adolescent↗