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Oral Health Assessment by Lay Personnel for Older Adults
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评估与健康相关的社会需求的4种方法的表现
Joshua R Vest1,2, Wei Wu3, Megan E Gregory4
1Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis.
JAMA network open
|August 18, 2025
概括
没有一种方法能够准确地衡量所有与健康相关的社会需求 (HRSN). 不同的方法显示在人口统计学方面表现不公平,可能低估了患者的需求.
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
- 健康 公平 卫生 公平
背景情况:
- 与健康相关的社会需求 (HRSN) 对患者护理和质量报告至关重要.
- 精确测量HRSNs对于有效的干预和资源分配至关重要.
研究的目的:
- 为了比较测量五个关键HRSN的四种方法的性能.
- 评估选问卷,自然语言处理 (NLP),基于规则的表型和机器学习 (ML) 模型.
主要方法:
- 一项涉及1252名来自初级保健诊所的成年患者的横截面研究.
- 将四种测量方法与粮食不安全,住房不稳定,财务压力,交通障碍和法律问题的参考标准进行了比较.
- 利用NLP,ML分类器,基于规则的表型和对电子健康记录数据应用的查问题.
主要成果:
- 大多数HRSN的查问题表现最好 (AUC为0.77-0.94),除了财务压力 (AUC为0.62).
- 基于NLP和基于规则的表型表现不佳;ML模型提供了更高的灵敏度.
- 所有方法都显示了跨性别,种族/族裔和年龄组的不公平表现,通过差异性的虚假阴性率表明了这一点.
结论:
- 没有一种单一的HRSN测量方法是普遍强大或公平的.
- 只依靠一种方法,就有可能低估患者所经历的真正的社会负担.
- 医疗机构必须考虑多种测量策略,并解决HRSN数据收集中的公平性.
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