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评估常规收集的与健康相关的社会需求措施的预测值
Samuel T Savitz1,2, Shealeigh Inselman1, Mark A Nyman2,3
1Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
Population health management
|October 30, 2023
概括
常规收集的患者报告的与健康相关的社会需求 (HRSN) 测量结果在预测患者结果方面显示出混合的结果. 临床因素和区域剥夺指数 (ADI) 是比HRSNs更重要的预测因素.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
- 预测建模预测建模
背景情况:
- 与健康相关的社会需求 (HRSNs) 越来越多地被收集起来,以了解患者的福祉.
- 评估这些常规收集的HRSN测量的预测价值对于医疗保健利用和结果至关重要.
研究的目的:
- 评估患者报告的HRSN措施在预测住院,再入院和死亡方面的有用性.
- 为了比较模型的预测性能,并没有常规收集的HRSN数据.
主要方法:
- 利用了梅奥诊所癌症,糖尿病或心力衰竭的患者的数据,这些患者被选为HRSNs.
- 采用了四种预测模型 (GBM,RF,GLM,EN),包括临床因素,人口统计和基于地区的措施 (ADI,农村).
- 使用曲线下的面积 (AUC) 和变量重要性变化的变化来评估模型性能.
主要成果:
- 添加常规收集的HRSN测量结果在不同疾病和结果组合的预测性表现中产生了混合的改进.
- 已建立的预测因素,如年龄,区域贫困指数 (ADI) 和查尔森并发症指数,比HRSN措施更为重要.
- 在癌症,糖尿病和心力衰竭结果的特定模型中观察到显著的AUC改善.
结论:
- 常规收集的患者报告的HRSN测量对预测关键医疗保健结果具有有限的混合影响.
- 现有的临床因素和区域级社会经济数据 (ADI) 目前是更强大的预测因素.
- 需要进一步的研究来确定可持续提高预测模型性能的HRSN措施.
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