A secure protocol for protecting the identity of providers when disclosing data for disease surveillance.
A secure protocol for protecting the identity of providers when disclosing data for disease surveillance.
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DOI：
10.1136/amiajnl-2011-000100
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发表时间：
2011-05-01
期刊：
影响因子：
--
通讯作者：
Earle C
中科院分区：
文献类型：
--
作者：
El Emam K;Hu J;Mercer J;Peyton L;Kantarcioglu M;Malin B;Buckeridge D;Samet S;Earle C
医疗服务提供商一直不愿出于公共卫生目的披露患者数据。即使患者隐私得到了保证，保护提供者机密性的愿望也是这种不情愿的重要驱动力。确定了监测协议的六项要求，以满足提供者的保密需求，并确保对公共卫生的实用性。作者使用Paillier密码系统开发了一个安全的多方计算协议，以允许披露分层的情况下计数和计算器，以满足这些要求。作者在模拟环境中评估了该协议的计算性能和检测疾病爆发集群的能力。理论和经验评估表明，方案满足所有要求。实现该协议的系统在计算时间方面随着提供者数量的增加而线性缩放。对于来自3000个实践的数据，执行计算的绝对时间为12.5秒。这是可接受的性能，因为报告通常每隔24小时完成一次。 与不安全的分布式监测协议相比，检测疾病暴发集群的准确性没有变化，涉及500例或更多病例的暴发的F分数高于0.92。该协议和相关软件为医疗服务提供者提供了一种实用的方法，可以在保护患者隐私和个人医疗服务提供者身份的同时，披露患者数据以进行哨点、综合征或其他基于指标的监测。
Providers have been reluctant to disclose patient data for public-health purposes. Even if patient privacy is ensured, the desire to protect provider confidentiality has been an important driver of this reluctance. Six requirements for a surveillance protocol were defined that satisfy the confidentiality needs of providers and ensure utility to public health. The authors developed a secure multi-party computation protocol using the Paillier cryptosystem to allow the disclosure of stratified case counts and denominators to meet these requirements. The authors evaluated the protocol in a simulated environment on its computation performance and ability to detect disease outbreak clusters. Theoretical and empirical assessments demonstrate that all requirements are met by the protocol. A system implementing the protocol scales linearly in terms of computation time as the number of providers is increased. The absolute time to perform the computations was 12.5 s for data from 3000 practices. This is acceptable performance, given that the reporting would normally be done at 24 h intervals. The accuracy of detection disease outbreak cluster was unchanged compared with a non-secure distributed surveillance protocol, with an F-score higher than 0.92 for outbreaks involving 500 or more cases. The protocol and associated software provide a practical method for providers to disclose patient data for sentinel, syndromic or other indicator-based surveillance while protecting patient privacy and the identity of individual providers.
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DOI：
10.3122/jabfm.2009.04.090081
发表时间：
2009-07-01
影响因子：
2.9
作者：
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通讯作者：
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影响因子：
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影响因子：
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DOI：
10.1197/jamia.m2902
发表时间：
2009-03-01
影响因子：
6.4
作者：
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通讯作者：
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