在放射治疗的背景下,对患者种族和事先授权计划决定之间的关联进行评估
Adam C Powell1, Christopher T Lugo2, Jeremy T Pickerell3
1HealthHelp, 16945 Northchase Drive, Suite 1300, Houston, TX, 77060, USA; Payer+Provider Syndicate, 20 Oakland Ave., Newton, MA, 02466, USA.
Healthcare (Amsterdam, Netherlands)
|August 20, 2023
概括
这项研究发现,使用临床决策支持系统 (CDSS) 的放射治疗事先授权,在确定订单适当性时没有显示种族偏见. 所有患者的结局是相似的,不论种族.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 放射治疗 (RT) 的医生订单必须经过事先授权,以确保指导方针一致.
- 临床决策支持系统 (CDSS) 标记了潜在的非指示RT订单,以便由瘤学家进一步审查.
- 在RT订单评估和结果中潜在的种族偏见是令人担忧的,尽管种族最初没有被捕获.
研究的目的:
- 评估患者种族与辐射治疗订单事先授权结果之间的关联.
- 确定基于规则的CDSS和整个事先授权过程是否引入了种族偏见.
主要方法:
- 分析了2019年来自Medicare Advantage患者的10,145个RT订单.
- 对所有癌症,特别是乳腺癌,肺癌和前列腺癌的种族和事先授权结果之间的关联进行了检查.
- 患者年龄,城市化和邮政编码中位数收入的统计控制,使用不匹配和种族匹配的样本.
主要成果:
- 在所有分析中,在种族和CDSS或事先授权结果之间没有发现显著的关联.
- 这项研究包括79.5%的白人和20.5%的黑人患者.
结论:
- 使用基于规则的CDSS的预先授权流程证明了在不引入种族偏见的情况下执行指南.
- 对不同种族的患者来说,放射治疗订单的临床适当性以相似的速度确定.
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