A fine-grained record integration and linkage tool (FRIL) is presented. The tool extends traditional record linkage tools with a richer set of parameters. Users may systematically and iteratively explore the optimal combination of parameter values to enhance linking performance and accuracy. Results of linking a birth defects monitoring program and birth certificate data using FRIL show 99% precision and 95% recall rates when compared to results obtained through handcrafted algorithms, and the process took significantly less time to complete. Experience and experimental result suggest that FRIL has the potential to increase the accuracy of data linkage across all studies involving record linkage. In particular, FRIL will enable researchers to assess objectively the quality of linked data.

Infectious disease emergency preparedness planners should consider the special medical issues of pregnant women.

Emerging infectious disease outbreaks and bioterrorism attacks warrant urgent public health and medical responses. Response plans for these events may include use of medications and vaccines for which the effects on pregnant women and fetuses are unknown. Healthcare providers must be able to discuss the benefits and risks of these interventions with their pregnant patients. Recent experiences with outbreaks of severe acute respiratory syndrome, monkeypox, and anthrax, as well as response planning for bioterrorism and pandemic influenza, illustrate the challenges of making recommendations about treatment and prophylaxis for pregnant women. Understanding the physiology of pregnancy, the factors that influence the teratogenic potential of medications and vaccines, and the infection control measures that may stop an outbreak will aid planners in making recommendations for care of pregnant women during large-scale infectious disease emergencies.