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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedMehta S, Lyles CR, Rubinsky AD
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
It is not clear how accurately Electronic health records (HER) data reflect patients' lived experience of social determinants of health (SDOH). The process of manually reviewing clinical notes to retrieve SDOH information is not feasible. The purpose of this study was to apply two tools, PatientExploreR and Electronic Medical Record Search Engine (EMERSE), to identify SDOH mappings for structured and unstructured patient data. The researchers included 4,283 adult patients receiving primary care for diabetes at UCSF. The study results revealed that SDOH may be more significant in the lives of patients with diabetes than is evident from structured data recorded on EHRs. When researchers applied EMERSE NLP rules, additional information was uncovered from patient clinical notes on problems related to social connections isolation, employment, financial insecurity, housing insecurity, food insecurity, education, and stress.
AHRQ-funded; HS026383.
Citation: Mehta S, Lyles CR, Rubinsky AD .
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
JMIR Med Inform 2023 Aug 22; 11:e46159. doi: 10.2196/46159..
Keywords: Social Determinants of Health, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Field C, Lynch CD, Fareed N
Association of community walkability and glycemic control among pregnant individuals with pregestational diabetes mellitus.
The role of community walkability in influencing glycemic regulation in expectant individuals with pre-existing diabetes is yet to be established. The purpose of this study was to explore the relationship between the walkability of a neighborhood at the community level and glycemic control, as indicated by hemoglobin A1c (A1C), in pregnant individuals with pregestational diabetes. The researchers conducted a retrospective examination of expectant individuals with pregestational diabetes who participated in a combined prenatal and diabetic care program from 2012 to 2016. The determinant of interest was community walkability, determined by the US Environmental Protection Agency National Walkability Index (score range 1-20), which includes intersection concentration (design), closeness to transit stops (distance), and a combination of job and household varieties (diversity). Participants from the most walkable neighborhoods were contrasted with those from less walkable neighborhoods as per the National Environmental Protection Agency's definition. The outcomes were glycemic control, including A1C, measured both in early and late pregnancy, and the average change in A1C throughout pregnancy. The study found that out of 417 expectant individuals, 10% resided in the most walkable areas. All 417 participants had an A1C assessment in early pregnancy, and 376 had another A1C assessment in late pregnancy. Pregnant individuals living in the most walkable areas were more likely to have an A1C <6.0% in early pregnancy, and an A1C <6.5% in late pregnancy compared with those in less walkable areas. The change in A1C across pregnancy was not related to walkability. The study concluded that individuals with pre-existing diabetes residing in more walkable areas demonstrated better glycemic control during both early and late pregnancy.
AHRQ-funded; HS028822.
Citation: Field C, Lynch CD, Fareed N .
Association of community walkability and glycemic control among pregnant individuals with pregestational diabetes mellitus.
Am J Obstet Gynecol MFM 2023 May; 5(5):100898. doi: 10.1016/j.ajogmf.2023.100898..
Keywords: Diabetes, Maternal Care, Social Determinants of Health, Women