Using routinely collected hospital data for child maltreatment surveillance : issues, methods and patterns

Background: International data on child maltreatment are largely derived from child protection agencies, and predominantly report only substantiated cases of child maltreatment. This approach underestimates the incidence of maltreatment and makes inter-jurisdictional comparisons difficult. There has been a growing recognition of the importance of health professionals in identifying, documenting and reporting suspected child maltreatment. This study aimed to describe the issues around case identification using coded morbidity data, outline methods for selecting and grouping relevant codes, and illustrate patterns of maltreatment identified. Methods: A comprehensive review of the ICD-10-AM classification system was undertaken, including review of index terms, a free text search of tabular volumes, and a review of coding standards pertaining to child maltreatment coding. Identified codes were further categorised into maltreatment types including physical abuse, sexual abuse, emotional or psychological abuse, and neglect. Using these code groupings, one year of Australian hospitalisation data for children under 18 years of age was examined to quantify the proportion of patients identified and to explore the characteristics of cases assigned maltreatment-related codes. Results: Less than 0.5% of children hospitalised in Australia between 2005 and 2006 had a maltreatment code assigned, almost 4% of children with a principal diagnosis of a mental and behavioural disorder and over 1% of children with an injury or poisoning as the principal diagnosis had a maltreatment code assigned. The patterns of children assigned with definitive T74 codes varied by sex and age group. For males selected as having a maltreatment-related presentation, physical abuse was most commonly coded (62.6% of maltreatment cases) while for females selected as having a maltreatment-related presentation, sexual abuse was the most commonly assigned form of maltreatment (52.9% of maltreatment cases). Conclusion: This study has demonstrated that hospital data could provide valuable information for routine monitoring and surveillance of child maltreatment, even in the absence of population-based linked data sources. With national and international calls for a public health response to child maltreatment, better understanding of, investment in and utilisation of our core national routinely collected data sources will enhance the evidence-base needed to support an appropriate response to children at risk.

Reliability of routinely collected hospital data for child maltreatment surveillance

Background: Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. Methods: A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. Results: In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most ‘under-coded’ by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability. Conclusion: Given the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting.

Getting research data ‘out there’ : collaborative solutions to identifying, describing and making research data more visible

At QUT research data refers to information that is generated or collected to be used as primary sources in the production of original research results, and which would be required to validate or replicate research findings (Callan, De Vine, & Baker, 2010). Making publicly funded research data discoverable by the broader research community and the public is a key aim of the Australian National Data Service (ANDS). Queensland University of Technology (QUT) has been innovating in this space by undertaking mutually dependant technical and content (metadata) focused projects funded by ANDS. Research Data Librarians identified and described datasets generated from Category 1 funded research at QUT, by interviewing researchers, collecting metadata and fashioning metadata records for upload to the Australian Research Data commons (ARDC) and exposure through the Research Data Australia interface. In parallel to this project, a Research Data Management Service and Metadata hub project were being undertaken by QUT High Performance Computing & Research Support specialists. These projects will collectively store and aggregate QUT’s metadata and research data from multiple repositories and administration systems and contribute metadata directly by OAI-PMH compliant feed to RDA. The pioneering nature of the work has resulted in a collaborative project dynamic where good data management practices and the discoverability and sharing of research data were the shared drivers for all activity. Each project’s development and progress was dependent on feedback from the other. The metadata structure evolved in tandem with the development of the repository and the development of the repository interface responded to meet the needs of the data interview process. The project environment was one of bottom-up collaborative approaches to process and system development which matched top-down strategic alliances crossing organisational boundaries in order to provide the deliverables required by ANDS. This paper showcases the work undertaken at QUT, focusing on the Seeding the Commons project as a case study, and illustrates how the data management projects are interconnected. It describes the processes and systems being established to make QUT research data more visible and the nature of the collaborations between organisational areas required to achieve this. The paper concludes with the Seeding the Commons project outcomes and the contribution this project made to getting more research data ‘out there’.

A criminological analysis : using real-time monitoring to gather data on online predators

The Internet presents a constantly evolving frontier for criminology and policing, especially in relation to online predators – paedophiles operating within the Internet for safer access to children, child pornography and networking opportunities with other online predators. The goals of this qualitative study are to undertake behavioural research – identify personality types and archetypes of online predators and compare and contrast them with behavioural profiles and other psychological research on offline paedophiles and sex offenders. It is also an endeavour to gather intelligence on the technological utilisation of online predators and conduct observational research on the social structures of online predator communities. These goals were achieved through the covert monitoring and logging of public activity within four Internet Relay Chat(rooms) (IRC) themed around child sexual abuse and which were located on the Undernet network. Five days of monitoring was conducted on these four chatrooms between Wednesday 1 to Sunday 5 April 2009; this raw data was collated and analysed. The analysis identified four personality types – the gentleman predator, the sadist, the businessman and the pretender – and eight archetypes consisting of the groomers, dealers, negotiators, roleplayers, networkers, chat requestors, posters and travellers. The characteristics and traits of these personality types and archetypes, which were extracted from the literature dealing with offline paedophiles and sex offenders, are detailed and contrasted against the online sexual predators identified within the chatrooms, revealing many similarities and interesting differences particularly with the businessman and pretender personality types. These personality types and archetypes were illustrated by selecting users who displayed the appropriate characteristics and tracking them through the four chatrooms, revealing intelligence data on the use of proxies servers – especially via the Tor software – and other security strategies such as Undernet’s host masking service. Name and age changes, which is used as a potential sexual grooming tactic was also revealed through the use of Analyst’s Notebook software and information on ISP information revealed the likelihood that many online predators were not using any safety mechanism and relying on the anonymity of the Internet. The activities of these online predators were analysed, especially in regards to child sexual grooming and the ‘posting’ of child pornography, which revealed a few of the methods in which online predators utilised new Internet technologies to sexually groom and abuse children – using technologies such as instant messengers, webcams and microphones – as well as store and disseminate illegal materials on image sharing websites and peer-to-peer software such as Gigatribe. Analysis of the social structures of the chatrooms was also carried out and the community functions and characteristics of each chatroom explored. The findings of this research have indicated several opportunities for further research. As a result of this research, recommendations are given on policy, prevention and response strategies with regards to online predators.

Decentralised Data Fusion with Parzen Density Estimates

Decentralised sensor networks typically consist of multiple processing nodes supporting one or more sensors. These nodes are interconnected via wireless communication. Practical applications of Decentralised Data Fusion have generally been restricted to using Gaussian based approaches such as the Kalman or Information Filter This paper proposes the use of Parzen window estimates as an alternate representation to perform Decentralised Data Fusion. It is required that the common information between two nodes be removed from any received estimates before local data fusion may occur Otherwise, estimates may become overconfident due to data incest. A closed form approximation to the division of two estimates is described to enable conservative assimilation of incoming information to a node in a decentralised data fusion network. A simple example of tracking a moving particle with Parzen density estimates is shown to demonstrate how this algorithm allows conservative assimilation of network information.

Rich probabilistic representations for bearing only decentralised data fusion

The aim of this paper is to demonstrate the validity of using Gaussian mixture models (GMM) for representing probabilistic distributions in a decentralised data fusion (DDF) framework. GMMs are a powerful and compact stochastic representation allowing efficient communication of feature properties in large scale decentralised sensor networks. It will be shown that GMMs provide a basis for analytical solutions to the update and prediction operations for general Bayesian filtering. Furthermore, a variant on the Covariance Intersect algorithm for Gaussian mixtures will be presented ensuring a conservative update for the fusion of correlated information between two nodes in the network. In addition, purely visual sensory data will be used to show that decentralised data fusion and tracking of non-Gaussian states observed by multiple autonomous vehicles is feasible.

Applying incremental EM to Bayesian classifiers in the learning of hyperspectral remote sensing data

In this paper, we apply the incremental EM method to Bayesian Network Classifiers to learn and interpret hyperspectral sensor data in robotic planetary missions. Hyperspectral image spectroscopy is an emerging technique for geological investigations from airborne or orbital sensors. Many spacecraft carry spectroscopic equipment as wavelengths outside the visible light in the electromagnetic spectrum give much greater information about an object. The algorithm used is an extension to the standard Expectation Maximisation (EM). The incremental method allows us to learn and interpret the data as they become available. Two Bayesian network classifiers were tested: the Naive Bayes, and the Tree-Augmented-Naive Bayes structures. Our preliminary experiments show that incremental learning with unlabelled data can improve the accuracy of the classifier.

Developing research data management services at QUT

QUT Library and the High Performance Computing and Research Support (HPC) Team have been collaborating on developing and delivering a range of research support services, including those designed to assist researchers to manage their data. QUT’s Management of Research Data policy has been available since 2010 and is complemented by the Data Management Guidelines and Checklist. QUT has partnered with the Australian Research Data Service (ANDS) on a number of projects including Seeding the Commons, Metadata Hub (with Griffith University) and the Data Capture program. The HPC Team has also been developing the QUT Research Data Repository based on the Architecta Mediaflux system and have run several pilots with faculties. Library and HPC staff have been trained in the principles of research data management and are providing a range of research data management seminars and workshops for researchers and HDR students.

An analysis of the variability in Queensland WiM data

The Queensland Department of Main Roads uses Weigh-in-Motion (WiM) devices to covertly monitor (at highway speed) axle mass, axle configurations and speed of heavy vehicles on the road network. Such data is critical for the planning and design of the road network. Some of the data appears excessively variable. The current work considers the nature, magnitude and possible causes of WiM data variability. Over fifty possible causes of variation in WiM data have been identified in the literature. Data exploration has highlighted five basic types of variability specifically: ----- • cycling, both diurnal and annual;----- • consistent but unreasonable data;----- • data jumps;----- • variations between data from opposite sides of the one road; and ----- • non-systematic variations.----- This work is part of wider research into procedures to eliminate or mitigate the influence of WiM data variability.

Linking ambulance, emergency department and hospital admissions data : understanding the emergency journey

Objective: to assess the accuracy of data linkage across the spectrum of emergency care in the absence of a unique patient identifier, and to use the linked data to examine service delivery outcomes in an emergency department setting. Design: automated data linkage and manual data linkage were compared to determine their relative accuracy. Data were extracted from three separate health information systems: ambulance, ED and hospital inpatients, then linked to provide information about the emergency journey of each patient. The linking was done manually through physical review of records and automatically using a data linking tool (Health Data Integration) developed by the CSIRO. Match rate and quality of the linking were compared. Setting: 10, 835 patient presentations to a large, regional teaching hospital ED over a two month period (August-September 2007). Results: comparison of the manual and automated linkage outcomes for each pair of linked datasets demonstrated a sensitivity of between 95% and 99%; a specificity of between 75% and 99%; and a positive predictive value of between 88% and 95%. Conclusions: Our results indicate that automated linking provides a sound basis for health service analysis, even in the absence of a unique patient identifier. The use of an automated linking tool yields accurate data suitable for planning and service delivery purposes and enables the data to be linked regularly to examine service delivery outcomes.

Using data mining on road asset management data in analysing road crashes

Road safety is a major concern worldwide. Road safety will improve as road conditions and their effects on crashes are continually investigated. This paper proposes to use the capability of data mining to include the greater set of road variables for all available crashes with skid resistance values across the Queensland state main road network in order to understand the relationships among crash, traffic and road variables. This paper presents a data mining based methodology for the road asset management data to find out the various road properties that contribute unduly to crashes. The models demonstrate high levels of accuracy in predicting crashes in roads when various road properties are included. This paper presents the findings of these models to show the relationships among skid resistance, crashes, crash characteristics and other road characteristics such as seal type, seal age, road type, texture depth, lane count, pavement width, rutting, speed limit, traffic rates intersections, traffic signage and road design and so on.

Road crash proneness prediction using data mining

Developing safe and sustainable road systems is a common goal in all countries. Applications to assist with road asset management and crash minimization are sought universally. This paper presents a data mining methodology using decision trees for modeling the crash proneness of road segments using available road and crash attributes. The models quantify the concept of crash proneness and demonstrate that road segments with only a few crashes have more in common with non-crash roads than roads with higher crash counts. This paper also examines ways of dealing with highly unbalanced data sets encountered in the study.

Identifying differences in wet and dry road crashes using data mining

It is commonly accepted that wet roads have higher risk of crash than dry roads; however, providing evidence to support this assumption presents some difficulty. This paper presents a data mining case study in which predictive data mining is applied to model the skid resistance and crash relationship to search for discernable differences in the probability of wet and dry road segments having crashes based on skid resistance. The models identify an increased probability of wet road segments having crashes for mid-range skid resistance values.

Comprehensive Australian Study of Entrepreneurial Emergence (CAUSEE): design, data collection and descriptive results

The Comprehensive Australian Study of Entrepreneurial Emergence (CAUSEE) is a research programme that aims to uncover the factors that initiate, hinder and facilitate the process of emergence of new economic activities and organizations. It is widely acknowledged that entrepreneurship is one of the most important forces shaping changes in a country’s economic landscape (Baumol 1968; Birch 1987; Acs 1999). An understanding of the process by which new economic activity and business entities emerge is vital (Gartner 1993; Sarasvathy 2001). An important development in the study of ‘nascent entrepreneurs’ and ‘firms in gestation’ was the Panel Study of Entrepreneurial Dynamics (PSED) (Gartner et al. 2004) and its extensions in Argentina, Canada, Greece, the Netherlands, Norway and Sweden. Yet while PSED I is an important first step towards systematically studying new venture emergence, it represents just the beginning of a stream of nascent venture studies – most notably PSED II is currently being undertaken in the US (2005– 10) (Reynolds and Curtin 2008).

Using data mining to predict road crash count with a focus on skid resistance values

Road crashes cost world and Australian society a significant proportion of GDP, affecting productivity and causing significant suffering for communities and individuals. This paper presents a case study that generates data mining models that contribute to understanding of road crashes by allowing examination of the role of skid resistance (F60) and other road attributes in road crashes. Predictive data mining algorithms, primarily regression trees, were used to produce road segment crash count models from the road and traffic attributes of crash scenarios. The rules derived from the regression trees provide evidence of the significance of road attributes in contributing to crash, with a focus on the evaluation of skid resistance.