Health data and privacy--Looking without looking

經(jīng)濟(jì)學(xué)人6月刊

The pandemic has sparked a new way to study sensitive medical records

ON MAY 7TH an article appeared on medRxiv, an online repository?for medical research. It showed, for England at least, the degrees to which SARS-CoV-2, the virus that causes covid-19,?discriminates?in its deadliness?between various groups of people. Men are more likely to die than women. The old and the socially deprived more likely than the young, well-off and well-connected. Those with uncontrolled diabetes or severe asthma, more likely than those without. And members of the country’s ethnic minorities more likely than those of its white majority.

medRxiv醫(yī)學(xué)預(yù)印本：是由美國冷泉港實(shí)驗(yàn)室、BMJ和耶魯大學(xué)聯(lián)合運(yùn)營的免費(fèi)的、非營利性服務(wù)平臺。所有醫(yī)學(xué)研究論文初始版本都可以以預(yù)印本方式在該平臺免費(fèi)發(fā)布，從而能實(shí)現(xiàn)科研成果及時地傳播，并獲得及時的反饋用以改進(jìn)研究，因此許多學(xué)者對其寄予了期望。

repository ?n. /r??p?z?tri/ 1.倉庫；貯藏室；存放處?2. 學(xué)識淵博的人；智囊；知識寶典

discriminate v. ??/d??skr?m?ne?t/??1.~ (between A and B)~ A from B ?區(qū)別；辨別；區(qū)分

2.[ V ] ~ (against sb)~ (in favour of sb) to treat one person or group worse/better than another in an unfair way 區(qū)別對待；歧視；偏袒

Deadliness?/'dedlinis/?n. 致命；深仇大恨；不共戴天??asthma n. ?/??sm?/ ?氣喘；哮喘

deprived adj. ?/d??pra?vd/ ?貧窮的；貧困的；窮苦的

? a deprived childhood/background/area 貧窮的童年╱出身╱地區(qū)

? economically/emotionally/socially deprived 經(jīng)濟(jì)困難的；感情失落的；社會遺棄的

None of these, even the first (for men are more vulnerable than women to quite a wide range of infections), is exactly a surprise. Even the finding that current smokers actually have a lower risk of death from the illness than do non-smokers, though superficially arresting, is in line with the results of other studies that used different methods—though a possible protective effect on asthma patients of steroid inhalers looks worth following up. But the actual results of this study are not really the remarkable thing about it. That, according to its lead author Ben Goldacre, a clinician and data scientist at the University of Oxford, is the method of analysis by which they were obtained. Instead of extracting sensitive patient records from the databases of the company which manages them on behalf of general practitioners?(GPs, Britain’s network of family doctors), the team behind the paper developed a suite of software that lets them run their massive analysis on the data?in situ.

superficially?/?su?p??f???li; ?sju?p??f???li/ 表面的，淺薄的

Arresting adj. 醒目的；引人注意的??steroid n. /?ster??d/類固醇；[有化] 甾族化合物?

inhaler n. /?n?he?l?(r)/. [臨床] 吸入器；空氣過濾器；吸入者

in situ adv. /??n ?s?tju?/ ?in the original or correct place 在原位；在原地；在合適的地方

The research was carried out by studying the medical records of some 17m people on the books of GPs in England and the 5,683 covid-attributable deaths therein. GPs are the first port of call in England’s National Health Service (NHS) for any non-emergency matter, and thus hold the most complete records of patients’ health. Studying these at this scale and degree of detail, with individual records linked up to causes of death, has never been done before. Merely making plans to?meddle with?such primary-care data has been a cause of great national concern in Britain in the past. Dr Goldacre’s research was possible only because of the?incentives?created by the pandemic, and the ingenuity of the group of epidemiologists and data scientists he assembled, who call themselves the OpenSAFELY Collective.

attributable? adj.?/??tr?bj?t?bl/??~ to sb/sth?probably caused by the thing mentioned?可歸因于；可能由于 ??Their illnesses are attributable to a poor diet.?他們的病可能是不良飲食所致。

there·in?adv.?在那里，在其中（指提及的地點(diǎn)、物體、文件等）

Meddle with: 瞎弄；亂動 ?incentive ?n. /?n?sent?v/ n. 動機(jī)；刺激 adj. 激勵的；刺激的

In normal circumstances, merely obtaining permission to look at such a trove?of sensitive health data would take months, perhaps years, of jumping through hoops held by ethics committees, computer-security checkers and so on. Running the analysis and getting it published might take months more. These are not, though, normal circumstances, and in fact it took OpenSAFELY a mere 42 days to go from idea to publication.

trove?/tr??v/==treasure trove?（有價值或令人喜愛的）藏品；無主財(cái)寶，埋藏物；寶庫

Three factors made this pace possible. The first is the existence of notices, signed by the country’s health minister, Matt Hancock, which give a wide range of people within the NHS broad licence to have access to and process health data in connection with fighting covid-19. These?Control of Patient Information (COPI) notices make it much easier to get data wrangling?done.

wrangle ?/?r??ɡl/ ?~ (with sb) (over sth)~ (between A and B) an argument that is complicated and continues over a long period of time （長時間的）爭論，爭吵

Numerous people close to the government’s digital efforts to fight the disease tell tales of COPI notices being waved in the faces of anyone who offers resistance to a particular data transfer. The OpenSAFELY team was acting on behalf of the NHS, and so had the power of the COPI notice behind its actions, speeding its way.

More important though, was the political heft arrayed under the OpenSAFELY banner. Academic expertise on electronic health records was provided by a team at the London School of Hygiene and Tropical Medicine, renowned for such work. The nitty gritty was covered by the Phoenix Partnership (TPP), a British company which stores, on behalf of GPs, the electronic health records of some 50m people. And Dr Goldacre himself is one of Britain’s foremost?medical glitterati. He was once a columnist on a national newspaper and has?nigh-on half a million followers on Twitter. His personal brand completed the picture, along with the data scientists and coders at his Evidence-Based Medicine DataLab in Oxford.

array?n. 數(shù)組，陣列；排列，列陣；大批，一系列；衣服?vt. 排列，部署；打扮

renown n. /r??na?n/ ?名譽(yù)；聲望? He won renown as a fair judge. 他贏得了公平裁判的榮譽(yù)。? a pianist of some/international/great renown 具有一定╱國際╱相當(dāng)知名度的鋼琴家

glitterati n. /?ɡl?t??rɑ?ti/ ?(used in newspapers) fashionable, rich and famous people （報(bào)章用語）時髦人物，風(fēng)云人物，知名人士

nigh adv. /na?/ ?1.~ on ( old-fashioned ) almost; nearly 幾乎；差不多??They've lived in that house for nigh on 30 years. 他們在那所房子里住了差不多30年了。 2.( old use ) ( literary ) near 靠近；近??Winter was drawing nigh. 冬天快到了。

The most important component of OpenSAFELY’s success, though, was its approach to the records themselves. It did not try to copy them, or move them out of TPP’s data centre for processing. Instead, its coders wrote software which let them perform their analysis within that data centre. Even then, Dr Goldacre’s crew were not given?free rein?to poke around?inside TPP’s systems. Instead they wrote a series of programs which let them interrogate?the patient records through a secure connection. A log was also kept of all queries?that the group ran on the records—thus the watchers were themselves watched.

crew /kru?/ ?

1.（輪船、飛機(jī)等上面的）全體工作人員 ?crew members 全體機(jī)務(wù)人員

2.（輪船、飛機(jī)等上面不包括高級職員的）全體船員，全體乘務(wù)員??the officers and crew 負(fù)責(zé)人員和全體乘務(wù)員

3. 技術(shù)人員團(tuán)隊(duì)；專業(yè)團(tuán)隊(duì)??a film/camera crew 電影攝制組；攝制組??an ambulance crew 救護(hù)車急救組

4.一群（或一幫、一伙）人??The people she invited were a pretty motley crew (= a strange mix of types of people) . 她邀請的人相當(dāng)混雜。

5.[ C+sing./pl.v. ] a team of people who row boats in races （賽船的）劃船隊(duì)員，劃船隊(duì)??a member of the Cambridge crew 劍橋大學(xué)劃船隊(duì)的隊(duì)員

6. 賽艇運(yùn)動??I'm thinking of going out for crew this semester (= joining the rowing team). 這學(xué)期我打算參加賽艇隊(duì)。

Free rein n. 完全的行動自由? ???poke arround: 閑逛

inter·rogate v. ??/?n?ter?ɡe?t/ ?

1.to ask sb a lot of questions over a long period of time, especially in an aggressive way 訊問；審問；盤問??He was interrogated by the police for over 12 hours. 他被警察審問了12個多小時。

2.( technical 術(shù)語 ) to obtain information from a computer or other machine （在計(jì)算機(jī)或其他機(jī)器上）查詢，詢問