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Abstract
Anonymization has the potential to foster the sharing of medical data. State-of-the-art methods use mathematical models to modify data to reduce privacy risks. However, the degree of protection must be balanced against the impact on statistical properties. We studied an extreme case of this trade-off: the statistical validity of an open medical dataset based on the German National Pandemic Cohort Network (NAPKON), which was prepared for publication using a strong anonymization procedure. Descriptive statistics and results of regression analyses were compared before and after anonymization of multiple variants of the original dataset. Despite significant differences in value distributions, the statistical bias was found to be small in all cases. In the regression analyses, the median absolute deviations of the estimated adjusted odds ratios for different sample sizes ranged from 0.01 [minimum = 0, maximum = 0.58] to 0.52 [minimum = 0.25, maximum = 0.91]. Disproportionate impact on the statistical properties of data is a common argument against the use of anonymization. Our analysis demonstrates that anonymization can actually preserve validity of statistical results in relatively low-dimensional data.
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1 University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777)
2 Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany (GRID:grid.484013.a) (ISNI:0000 0004 6879 971X)
3 University of Wuerzburg, Faculty of Medicine, Institute for Clinical Epidemiology and Biometry, Wuerzburg, Germany (GRID:grid.8379.5) (ISNI:0000 0001 1958 8658)
4 University of Bielefeld, Department of Cardiology and Intensive Care Medicine, Bielefeld Medical Centre, Medical Faculty OWL, Bielefeld, Germany (GRID:grid.7491.b) (ISNI:0000 0001 0944 9128)
5 Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662)
6 University Medical Center Schleswig-Holstein Campus Kiel, Internal Medicine Department I, Kiel, Germany (GRID:grid.412468.d) (ISNI:0000 0004 0646 2097)
7 University Hospital of Ludwig-Maximilians-University (LMU), Department of Anesthesiology, Munich, Germany (GRID:grid.5252.0) (ISNI:0000 0004 1936 973X); University Hospital, LMU Munich, Department of Medicine III, Munich, Germany (GRID:grid.411095.8) (ISNI:0000 0004 0477 2585)
8 Technical University of Munich, School of Medicine, University Hospital rechts der Isar, Department of Internal Medicine II, Munich, Germany (GRID:grid.6936.a) (ISNI:0000000123222966)
9 University Hospital, LMU Munich, Department of Medicine III, Munich, Germany (GRID:grid.411095.8) (ISNI:0000 0004 0477 2585); University Hospital, LMU Munich, COVID-19 Registry of the LMU Munich (CORKUM), Munich, Germany (GRID:grid.411095.8) (ISNI:0000 0004 0477 2585)
10 University Medical Center Schleswig-Holstein Campus Kiel, Internal Medicine Department I, Kiel, Germany (GRID:grid.412468.d) (ISNI:0000 0004 0646 2097); Airway Research Center North (ARCN), German Center for Lung Research (DZL), Großhansdorf, Germany (GRID:grid.452624.3)
11 University Hospital Frankfurt, Department II for Internal Medicine, Hematology/Oncology, Frankfurt am Main, Germany (GRID:grid.411088.4) (ISNI:0000 0004 0578 8220)
12 University Hospital Wuerzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Wuerzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891)
13 University Hospital Regensburg, Department of Infection Prevention and Infectious Diseases, Regensburg, Germany (GRID:grid.411941.8) (ISNI:0000 0000 9194 7179)
14 Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Giessen, Germany (GRID:grid.8664.c) (ISNI:0000 0001 2165 8627); The Cardio-Pulmonary Institute (CPI), Giessen, Germany (GRID:grid.511808.5)
15 Charité-Universitätsmedizin Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662)
16 University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777); University Hospital Frankfurt, Department II for Internal Medicine, Hematology/Oncology, Frankfurt am Main, Germany (GRID:grid.411088.4) (ISNI:0000 0004 0578 8220); partner site Bonn-Cologne, German Centre for Infection Research (DZIF), Cologne, Germany (GRID:grid.452463.2)
17 Hannover Medical School, Hannover Unified Biobank, Hannover, Germany (GRID:grid.10423.34) (ISNI:0000 0000 9529 9877)
18 Helmholtz Center Munich, Institute of Epidemiology, Munich, Germany (GRID:grid.4567.0) (ISNI:0000 0004 0483 2525)
19 University Hospital Cologne and University Hospital Frankfurt, Cologne and Frankfurt, Germany (GRID:grid.411097.a) (ISNI:0000 0000 8852 305X)
20 University Hospital Cologne, Cologne, Germany (GRID:grid.411097.a) (ISNI:0000 0000 8852 305X)
21 University Hospital Frankfurt, Frankfurt am Main, Germany (GRID:grid.411088.4) (ISNI:0000 0004 0578 8220)
22 Charité - Universitaetsmedizin Berlin, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662)
23 University of Wuerzburg, Wuerzburg, Germany (GRID:grid.8379.5) (ISNI:0000 0001 1958 8658)
24 University of Kiel, Kiel, Germany (GRID:grid.9764.c) (ISNI:0000 0001 2153 9986)
25 University Hospital LMU Munich, Munich, Germany (GRID:grid.411095.8) (ISNI:0000 0004 0477 2585)
26 University Medicine Greifswald, Greifswald, Germany (GRID:grid.5603.0)
27 University Medical Center Goettingen, Goettingen, Germany (GRID:grid.411984.1) (ISNI:0000 0001 0482 5331)
28 German Center for Cardiovascular Diseases (DZHK), Berlin, Germany (GRID:grid.452396.f) (ISNI:0000 0004 5937 5237)
29 Cnopfsche Children’s Hospital, Nuernberg, Germany (GRID:grid.6363.0)
30 Hannover Medical School, Hannover, Germany (GRID:grid.10423.34) (ISNI:0000 0000 9529 9877)
31 Justus Liebig University Giessen & Marburg, Gießen and Marburg, Germany (GRID:grid.8664.c) (ISNI:0000 0001 2165 8627)
32 Klinikum Dortmund, Dortmund, Germany (GRID:grid.473616.1) (ISNI:0000 0001 2200 2697)
33 Malteser Hospital St. Franziskus Hospital, Flensburg, Germany (GRID:grid.411095.8)
34 MVZ am Isartor, Muenchen, Germany (GRID:grid.411095.8)
35 Medical Faculty Mannheim, Mannheim, Germany (GRID:grid.411095.8)
36 Practice for general medicine Am Ebertplatz, Cologne, Germany (GRID:grid.411095.8)
37 Practice for general medicine Dr. Allerlei, Frankfurt am Main, Germany (GRID:grid.411095.8)
38 Saarland University, Homburg, Germany (GRID:grid.11749.3a) (ISNI:0000 0001 2167 7588)
39 Saarland University Hospital, Homburg, Germany (GRID:grid.411937.9)
40 Tropical Hospital Paul-Lechler-Krankenhaus, Tuebingen, Germany (GRID:grid.411937.9)
41 University Hospital Augsburg, Augsburg, Germany (GRID:grid.419801.5) (ISNI:0000 0000 9312 0220)
42 University Hospital Carl Gustav Carus, Dresden, Germany (GRID:grid.412282.f) (ISNI:0000 0001 1091 2917)
43 University Hospital Erlangen, Erlangen, Germany (GRID:grid.411668.c) (ISNI:0000 0000 9935 6525)
44 University Hospital Hamburg-Eppendorf, Hamburg, Germany (GRID:grid.13648.38) (ISNI:0000 0001 2180 3484)
45 University Hospital Greifswald, Greifswald, Germany (GRID:grid.412469.c) (ISNI:0000 0000 9116 8976)
46 University Hospital Leipzig, Leipzig, Germany (GRID:grid.411339.d) (ISNI:0000 0000 8517 9062)
47 University Hospital Muenster, Muenster, Germany (GRID:grid.16149.3b) (ISNI:0000 0004 0551 4246)
48 University Medicine Oldenburg, Oldenburg, Germany (GRID:grid.16149.3b)
49 University Hospital Regensburg, Regensburg, Germany (GRID:grid.411941.8) (ISNI:0000 0000 9194 7179)
50 University Hospital RWTH Aachen, Aachen, Germany (GRID:grid.412301.5) (ISNI:0000 0000 8653 1507)
51 University Hospital Schleswig-Holstein, Kiel and Luebeck, Germany (GRID:grid.412468.d) (ISNI:0000 0004 0646 2097)
52 University Hospital Technical University Munich, Munich, Germany (GRID:grid.6936.a) (ISNI:0000000123222966)
53 University Hospital Tuebingen, Tuebingen, Germany (GRID:grid.411544.1) (ISNI:0000 0001 0196 8249)
54 University Hospital Wuerzburg, Wuerzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891)
55 University Hospitals of the Ruhr University Bochum, Bochum, Germany (GRID:grid.5570.7) (ISNI:0000 0004 0490 981X)
56 Bielefeld University, Medical School and University Medical Center East Westphalia-Lippe, Bielefeld, Germany (GRID:grid.7491.b) (ISNI:0000 0001 0944 9128)
57 University Medical Center Freiburg, Freiburg, Germany (GRID:grid.7708.8) (ISNI:0000 0000 9428 7911)
58 University Medicine Essen, Essen, Germany (GRID:grid.411984.1)
59 Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany (GRID:grid.13652.33) (ISNI:0000 0001 0940 3744)
60 Jena University Hospital, Jena, Germany (GRID:grid.275559.9) (ISNI:0000 0000 8517 6224)
61 Lahn-Dill-Clinics, Wetzlar, Germany (GRID:grid.275559.9)