Feller Daniel J, Zucker Jason, Walk Oliver Bear Don't, Yin Michael T, Gordon Peter, Elhadad Noémie
Department of Biomedical Informatics, Columbia University, New York, NY, USA.
Division of Infectious Diseases, Department of Medicine, Columbia University, New York, NY USA.
AMIA Annu Symp Proc. 2020 Mar 4;2019:399-407. eCollection 2019.
Social and behavioral determinants of health (SBDH) are environmental and behavioral factors that impede disease self-management and can exacerbate clinical conditions. While recent research in the informatics community has focused on building systems that can automatically infer SBDH from the patient record, it is unclear how such determinants change overtime. This study analyzes the longitudinal characteristics of 4 common SBDH as expressed in the patient record and compares the rates of change among distinct SBDH. In addition, manual review of patient notes was undertaken to establish whether changes in patient SBDH status reflected legitimate changes in patient status or rather potential data quality issues. Our findings suggest that a patient's SBDH status is liable to change over time and that some changes reflect poor social history taking by clinicians.
健康的社会和行为决定因素（SBDH）是阻碍疾病自我管理并可能加剧临床状况的环境和行为因素。虽然信息学领域最近的研究集中在构建能够从患者记录中自动推断SBDH的系统，但尚不清楚这些决定因素如何随时间变化。本研究分析了患者记录中所表达的4种常见SBDH的纵向特征，并比较了不同SBDH之间的变化率。此外，还对患者记录进行了人工审查，以确定患者SBDH状态的变化是反映了患者状态的合理变化还是潜在的数据质量问题。我们的研究结果表明，患者的SBDH状态可能随时间变化，并且一些变化反映了临床医生对社会病史记录的不足。
