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Journal of the American Medical Informatics Association
Article . 2025 . Peer-reviewed
License: CC BY NC
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Incorporating area-level social drivers of health in predictive algorithms using electronic health record data

Authors: Agata Foryciarz; Nicole Gladish; David H Rehkopf; Sherri Rose;

Incorporating area-level social drivers of health in predictive algorithms using electronic health record data

Abstract

Abstract Objectives The inclusion of social drivers of health (SDOH) into predictive algorithms of health outcomes has potential for improving algorithm interpretation, performance, generalizability, and transportability. However, there are limitations in the availability, understanding, and quality of SDOH variables, as well as a lack of guidance on how to incorporate them into algorithms when appropriate to do so. As such, few published algorithms include SDOH, and there is substantial methodological variability among those that do. We argue that practitioners should consider the use of social indices and factors—a class of area-level measurements—given their accessibility, transparency, and quality. Results We illustrate the process of using such indices in predictive algorithms, which includes the selection of appropriate indices for the outcome, measurement time, and geographic level, in a demonstrative example with the Kidney Failure Risk Equation. Discussion Identifying settings where incorporating SDOH may be beneficial and incorporating them rigorously can help validate algorithms and assess generalizability.

Related Organizations
Keywords

Social Determinants of Health, Perspective, Humans, Electronic Health Records, Renal Insufficiency, Algorithms

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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
Green
hybrid