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Duah HO, Boch S, Arter S, Nidey N, Lambert J. A guide to understanding big data for the nurse scientist: A discursive paper. Nurs Inq 2024:e12648. [PMID: 38865286 DOI: 10.1111/nin.12648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 06/14/2024]
Abstract
Big data refers to extremely large data generated at high volume, velocity, variety, and veracity. The nurse scientist is uniquely positioned to leverage big data to suggest novel hypotheses on patient care and the healthcare system. The purpose of this paper is to provide an introductory guide to understanding the use and capability of big data for nurse scientists. Herein, we discuss the practical, ethical, social, and educational implications of using big data in nursing research. Some practical challenges with the use of big data include data accessibility, data quality, missing data, variable data standards, fragmentation of health data, and software considerations. Opposing ethical positions arise with the use of big data, and arguments for and against the use of big data are underpinned by concerns about confidentiality, anonymity, and autonomy. The use of big data has health equity dimensions and addressing equity in data is an ethical imperative. There is a need to incorporate competencies needed to leverage big data for nursing research into advanced nursing educational curricula. Nursing science has a great opportunity to evolve and embrace the potential of big data. Nurse scientists should not be spectators but collaborators and drivers of policy change to better leverage and harness the potential of big data.
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Affiliation(s)
- Henry Ofori Duah
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
| | - Samantha Boch
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Sara Arter
- Department of Nursing, Miami University, Hamilton, Ohio, USA
| | - Nichole Nidey
- College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Joshua Lambert
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
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Kumar D, Suthar N. Predictive analytics and early intervention in healthcare social work: a scoping review. SOCIAL WORK IN HEALTH CARE 2024; 63:208-229. [PMID: 38349783 DOI: 10.1080/00981389.2024.2316700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/05/2024] [Indexed: 02/15/2024]
Abstract
This scoping review investigates the untapped potential of predictive analytics in healthcare social work, specifically targeting early intervention frameworks. Despite the escalating attention predictive analytics has garnered across multiple disciplines, its tailored application in social work remains notably sparse. This study endeavors to fill this lacuna by meticulously reviewing the extant literature and delineating the prospective advantages and inherent constraints of integrating predictive analytics into healthcare social work. The outcomes of this inquiry enrich the prevailing dialogue on the utility of predictive analytics in healthcare, offering indispensable perspectives for practitioners and policymakers in the social work domain.
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Affiliation(s)
- Dinesh Kumar
- Faculty of Business and Applied Arts, Lovely Professional University, Mittal School of Business, Phagwara, India
| | - Nidhi Suthar
- Administration, Pomento IT Services, Hisar, India
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Lemont B, Puro N, Franz B, Cronin CE. Efforts by critical access hospitals to increase health equity through greater engagement with social determinants of health. J Rural Health 2023; 39:728-736. [PMID: 37296509 DOI: 10.1111/jrh.12771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/21/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Greater health care engagement with social determinants of health (SDOH) is critical to improving health equity. However, no national studies have compared programs to address patient social needs among critical access hospitals (CAHs), which are lifelines for rural communities. CAHs generally have fewer resources and receive governmental support to maintain operations. This study considers the extent to which CAHs engage in community health improvement, particularly upstream SDOH, and whether organizational or community factors predict involvement. METHODS Using descriptive statistics and Poisson regression, we compared 3 types of programs (screening, in-house strategies, and external partnerships) to address the patient social needs between CAHs and non-CAHs, independent of key organizational, county, and state factors. FINDINGS CAHs were less likely than non-CAHs to have programs to screen patients for social needs, address unmet social needs of patients, and enact community partnerships to address SDOH. When we stratified hospitals according to whether they endorsed an equity-focused approach as an organization, CAHs matched their non-CAH counterparts on all 3 types of programs. CONCLUSIONS CAHs lag relative to their urban and non-CAH counterparts in their ability to address nonmedical needs of their patients and broader communities. While the Flex Program has shown success in offering technical assistance to rural hospitals, this program has mainly focused on traditional hospital services to address patients' acute health care needs. Our findings suggest that organizational and policy efforts surrounding health equity could bring CAHs in line with other hospitals in terms of their ability to support rural population health.
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Affiliation(s)
- Bethany Lemont
- Economics Department, Ohio University College of Arts & Sciences; Appalachian Institute to Advance Health Equity Science, Athens, Ohio, USA
| | - Neeraj Puro
- Management-Health Administration, Florida Atlantic University College of Business, Boca Raton, Florida, USA
| | - Berkeley Franz
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine; Appalachian Institute to Advance Health Equity Science, Athens, Ohio, USA
| | - Cory E Cronin
- Department of Social and Public Health, Ohio University College of Health Sciences and Professions; Appalachian Institute to Advance Health Equity Science, Athens, Ohio, USA
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Adams AS. Charting the Course Toward More Equitable Health Care Systems. Med Care 2023; 61:1-2. [PMID: 36477615 PMCID: PMC9752198 DOI: 10.1097/mlr.0000000000001796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Alyce S Adams
- Departments of Health Policy, Epidemiology and Population Health, and (by courtesy) Pediatrics, Stanford School of Medicine, Stanford, CA
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Hatef E, Rouhizadeh M, Nau C, Xie F, Rouillard C, Abu-Nasser M, Padilla A, Lyons LJ, Kharrazi H, Weiner JP, Roblin D. Development and assessment of a natural language processing model to identify residential instability in electronic health records’ unstructured data: a comparison of 3 integrated healthcare delivery systems. JAMIA Open 2022; 5:ooac006. [PMID: 35224458 PMCID: PMC8867582 DOI: 10.1093/jamiaopen/ooac006] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/03/2022] [Accepted: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
To evaluate whether a natural language processing (NLP) algorithm could be adapted to extract, with acceptable validity, markers of residential instability (ie, homelessness and housing insecurity) from electronic health records (EHRs) of 3 healthcare systems.
Materials and methods
We included patients 18 years and older who received care at 1 of 3 healthcare systems from 2016 through 2020 and had at least 1 free-text note in the EHR during this period. We conducted the study independently; the NLP algorithm logic and method of validity assessment were identical across sites. The approach to the development of the gold standard for assessment of validity differed across sites. Using the EntityRuler module of spaCy 2.3 Python toolkit, we created a rule-based NLP system made up of expert-developed patterns indicating residential instability at the lead site and enriched the NLP system using insight gained from its application at the other 2 sites. We adapted the algorithm at each site then validated the algorithm using a split-sample approach. We assessed the performance of the algorithm by measures of positive predictive value (precision), sensitivity (recall), and specificity.
Results
The NLP algorithm performed with moderate precision (0.45, 0.73, and 1.0) at 3 sites. The sensitivity and specificity of the NLP algorithm varied across 3 sites (sensitivity: 0.68, 0.85, and 0.96; specificity: 0.69, 0.89, and 1.0).
Discussion
The performance of this NLP algorithm to identify residential instability in 3 different healthcare systems suggests the algorithm is generally valid and applicable in other healthcare systems with similar EHRs.
Conclusion
The NLP approach developed in this project is adaptable and can be modified to extract types of social needs other than residential instability from EHRs across different healthcare systems.
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Affiliation(s)
- Elham Hatef
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Masoud Rouhizadeh
- Institute for Clinical and Translational Research, Johns Hopkins Medical Institute, Baltimore, Maryland, USA
| | - Claudia Nau
- Kaiser Permanente Southern Caifornia, Pasadena, California, USA
| | - Fagen Xie
- Kaiser Permanente Southern Caifornia, Pasadena, California, USA
| | | | | | - Ariadna Padilla
- Kaiser Permanente Southern Caifornia, Pasadena, California, USA
| | | | - Hadi Kharrazi
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Medicine Division of Health Sciences Informatics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jonathan P Weiner
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Douglas Roblin
- Kaiser Permanente Mid-Atlantic States, Rockville, Maryland, USA
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Samuels‐Kalow ME, Ciccolo GE, Lin MP, Schoenfeld EM, Camargo CA. The terminology of social emergency medicine: Measuring social determinants of health, social risk, and social need. J Am Coll Emerg Physicians Open 2020; 1:852-856. [PMID: 33145531 PMCID: PMC7593464 DOI: 10.1002/emp2.12191] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 01/12/2023] Open
Abstract
Emergency medicine has increasingly focused on addressing social determinants of health (SDoH) in emergency medicine. However, efforts to standardize and evaluate measurement tools and compare results across studies have been limited by the plethora of terms (eg, SDoH, health-related social needs, social risk) and a lack of consensus regarding definitions. Specifically, the social risks of an individual may not align with the social needs of an individual, and this has ramifications for policy, research, risk stratification, and payment and for the measurement of health care quality. With the rise of social emergency medicine (SEM) as a field, there is a need for a simplified and consistent set of definitions. These definitions are important for clinicians screening in the emergency department, for health systems to understand service needs, for epidemiological tracking, and for research data sharing and harmonization. In this article, we propose a conceptual model for considering SDoH measurement and provide clear, actionable, definitions of key terms to increase consistency among clinicians, researchers, and policy makers.
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Affiliation(s)
- Margaret E. Samuels‐Kalow
- Department of Emergency MedicineMassachusetts General HospitalHarvard Medical SchoolMassachusettsUSA
| | - Gia E. Ciccolo
- Department of Emergency MedicineMassachusetts General HospitalHarvard Medical SchoolMassachusettsUSA
| | - Michelle P. Lin
- Department of Emergency MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Elizabeth M. Schoenfeld
- Department of Emergency Medicine and Institute for Healthcare Delivery and Population ScienceUniversity of Massachusetts Medical School – BaystateSpringfieldMassachusettsUSA
| | - Carlos A. Camargo
- Department of Emergency MedicineMassachusetts General HospitalHarvard Medical SchoolMassachusettsUSA
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Tan M, Hatef E, Taghipour D, Vyas K, Kharrazi H, Gottlieb L, Weiner J. Including Social and Behavioral Determinants in Predictive Models: Trends, Challenges, and Opportunities. JMIR Med Inform 2020; 8:e18084. [PMID: 32897240 PMCID: PMC7509627 DOI: 10.2196/18084] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/17/2020] [Accepted: 07/20/2020] [Indexed: 12/18/2022] Open
Abstract
In an era of accelerated health information technology capability, health care organizations increasingly use digital data to predict outcomes such as emergency department use, hospitalizations, and health care costs. This trend occurs alongside a growing recognition that social and behavioral determinants of health (SBDH) influence health and medical care use. Consequently, health providers and insurers are starting to incorporate new SBDH data sources into a wide range of health care prediction models, although existing models that use SBDH variables have not been shown to improve health care predictions more than models that use exclusively clinical variables. In this viewpoint, we review the rationale behind the push to integrate SBDH data into health care predictive models and explore the technical, strategic, and ethical challenges faced as this process unfolds across the United States. We also offer several recommendations to overcome these challenges to reach the promise of SBDH predictive analytics to improve health and reduce health care disparities.
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Affiliation(s)
- Marissa Tan
- General Preventive Medicine Residency Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Elham Hatef
- General Preventive Medicine Residency Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Center for Population Health Information Technology, Baltimore, MD, United States
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Delaram Taghipour
- General Preventive Medicine Residency Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kinjel Vyas
- Division of Health Sciences Informatics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Hadi Kharrazi
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Center for Population Health Information Technology, Baltimore, MD, United States
- Division of Health Sciences Informatics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Laura Gottlieb
- Social Interventions Research and Evaluation Network, Center for Health & Community, University of California, San Francisco, CA, United States
| | - Jonathan Weiner
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Center for Population Health Information Technology, Baltimore, MD, United States
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