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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jan 27, 2025
Date Accepted: Aug 17, 2025

The final, peer-reviewed published version of this preprint can be found here:

The Advanced Confidentiality Engine as a Scalable Tool for the Pseudonymization of Biomedical Data in Translational Settings: Development and Usability Study

Müller A, Wündisch E, Wirth FN, Meier zu Ummeln S, Weber J, Prasser F

The Advanced Confidentiality Engine as a Scalable Tool for the Pseudonymization of Biomedical Data in Translational Settings: Development and Usability Study

J Med Internet Res 2025;27:e71822

DOI: 10.2196/71822

PMID: 41191920

PMCID: 12631087

The Advanced Confidentiality Engine (ACE) - A Scalable Tool for the Pseudonymization of Biomedical Data in Translational Settings: Development and Usability Study

  • Armin Müller; 
  • Eric Wündisch; 
  • Felix Nikolaus Wirth; 
  • Sophie Meier zu Ummeln; 
  • Joachim Weber; 
  • Fabian Prasser

ABSTRACT

Background:

Pseudonymization refers to a process in which data that directly identifies individuals, such as names and addresses, are stored separately from data needed for scientific purposes. The connection between both types of data is maintained through a protected link, represented by pseudonyms. This is a central data protection method in translational research, which enables researchers to collect, process, and share data while adhering to “data protection by design and by default” and data minimization best practices. However, integrating pseudonymization into high-throughput data processing workflows is challenging and open-source solutions are rare.

Objective:

This paper introduces the Advanced Confidentiality Engine (ACE), a highly scalable open-source pseudonymization service focused on creating and managing the protected link between identifying and research data.

Methods:

ACE has been designed to have a lean architecture, consisting of a compact database schema that mimics the design of data warehouses. It is implemented using modern open-source software technologies and provides a Representational State Transfer (REST) Application Programming Interface (API). Amongst its features are a fine-grained access control mechanism, a domain-based structuring of pseudonyms with attribute inheritance and a comprehensive audit trail. We performed a structured evaluation to study ACE's scalability under various workload scenarios.

Results:

For generating protected links, ACE supports nine different pseudonymization algorithms, including approaches based on cryptographic primitives and random number generation. Pseudonyms can be encoded using different alphabets that can be combined with check digits. Pseudonyms can be annotated with metadata, such as validity periods, and those properties can be inherited through a hierarchical domain structure. As all information is persisted by ACE, it supports pseudonymization and de-pseudonymization for which access can be controlled individually. Our experiments show that ACE is able to handle thousands of transactions per second in different workload settings. ACE combines the efficiency of cryptography-based pseudonymization methods with the flexibility of persistence-based approaches.

Conclusions:

ACE is a modern and highly scalable implementation of a pseudonymization service tailored towards the specific requirements in biomedical research. It is available as open-source software. As the space of openly available pseudonymization services is limited, we believe that ACE is valuable to institutions establishing or improving their translational data infrastructure.


 Citation

Please cite as:

Müller A, Wündisch E, Wirth FN, Meier zu Ummeln S, Weber J, Prasser F

The Advanced Confidentiality Engine as a Scalable Tool for the Pseudonymization of Biomedical Data in Translational Settings: Development and Usability Study

J Med Internet Res 2025;27:e71822

DOI: 10.2196/71822

PMID: 41191920

PMCID: 12631087

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