A simple patient screening survey that addresses five different health-related social needs (HRSNs), including food insecurity, housing instability, financial burden, transportation barriers, and legal issues, is superior to advanced machine learning methods in tracking HRSNs. This is according to a new study led by researchers at Fairbanks School Andregen Streef Institute. However, the author emphasized that there is no perfect way. Each had a gap.
This study examined data from 1,252 adult patients ages 18 to 99 years from two Indianapolis health systems from January 2022 to June 2023, and used four different measurement approaches to track HRSN. These measures were electronic health records (EHR) screening surveys, natural language processing (NLP) for clinical notes, rule-based algorithms, and machine learning models (MLMS).
The EHR screening questions were the strongest overall performance of the measurement approach to food insecurity, housing instability, transportation barriers and legal issues, but all measures struggled to measure financial tension. NLP showed poor performance in all five HRSNs and showed a higher specificity than sensitivity for all HRSNs. This algorithm was not superior to Coinflip due to food insecurity, housing instability, transportation barriers and legal issues. The classification of ML financial tensions was poor, but was superior to all other methods.
Overall, the screening questionnaire was optimal, but the measurement approach did not work well for each HRSN compared to the measurements in the reference standard. The authors suggest that researchers who rely on a single method to collect HRSN data are more likely to underestimate the burden of patients' true social needs.
“The health system is increasingly recognised that social factors are important to healthcare, but it is not always clear how to identify patients with those needs in everyday practice,” explained Joshua Vest, a research scientist at the Regentrief Institute and professor of health policy and management at Fairbanks School. “Our research shows that questionnaires are a strong starting point, but we cannot rely on a single method to grasp the full scope of patients' social needs.”
Social Determinants of Health – According to the Department of Disease Prevention and Health Promotion, the conditions of the environment that affect people born and live, learning, work, play, worship, and age are increasingly linked to the well-being and outcomes of healthcare and healthcare.
