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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 622 Research Studies Displayed
Wurcel AG, Essien UR, Ortiz C
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
This cohort study examined antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs). A subanalysis of multisite, cross-sectional data collected through a national survey of acute care hospital groups within Vizient, Inc. considering adult inpatients treated for SSTIs was used. Of the 1242 adult inpatients included from 91 US hospitals, 45% were female, 18% were Black, and 69% were White with a mean age of 58 years. Penicillin allergy with hives was found in 23%, 19% with rash, and 18% with unknown effects, with allergy found more frequent in Black patients (23%) versus White (18%). Adjusting for multiple factors, White inpatients were at an increased risk of cefazolin use and decreased risk of clindamycin use compared with Black inpatients. Cefazolin use with less likely to be prescribed to Black inpatients than White inpatients and they were likely to be prescribed clindamycin. Cefazolin is considered a first-line SSTI treatment with clindamycin not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection (CDI). Although penicillin allergy is described as more prevalent among White patients, the authors observed an increased prevalence among Black inpatients compared with White inpatients treated for SSTI.
Citation:
Wurcel AG, Essien UR, Ortiz C .
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
JAMA Netw Open 2021 Dec;4(12):e2140798. doi: 10.1001/jamanetworkopen.2021.40798..
Keywords:
Antibiotics, Skin Conditions, Racial / Ethnic Minorities, Practice Patterns, Medication
Jacobs PD, Abdus S
Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States.
Researchers examined whether widespread eligibility for Medicare at age 65 narrows disparate preventive service use by race and ethnicity. Using MEPS data and examining six preventive services, they found that, for non-Hispanic Black adults, preventive service use increased after age 65. Further, for all four preventive health measures that were lower for Hispanic adults compared with non-Hispanic White adults prior to age 65, service use was indistinguishable between these groups after reaching the Medicare eligibility age. They concluded that Medicare eligibility appeared to reduce most racial and ethnic disparities in preventive service use.
AHRQ-authored.
Citation:
Jacobs PD, Abdus S .
Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States.
Prev Med 2022 Apr;157:106996. doi: 10.1016/j.ypmed.2022.106996..
Keywords:
Medical Expenditure Panel Survey (MEPS), Racial / Ethnic Minorities, Medicare, Prevention, Access to Care, Disparities, Health Insurance
Jindal M, Mistry KB, McRae A
"It makes me a better person and doctor": a qualitative study of residents' perceptions of a curriculum addressing racism.
The purpose of this study was to explore how pediatric residents perceive the impact of a curriculum addressing racism on their knowledge, motivation, skills and behaviors and investigate the contextual factors that promote or impede the curriculum's effectiveness. Semi structured interviews were conducted at two academic medical centers among pediatric residents. Findings showed that medical education addressing racism can facilitate the perceived acquisition of foundational knowledge regarding race and racism, motivation and skill-building to combat racism, and action planning aimed at improving patient care.
AHRQ-authored.
Citation:
Jindal M, Mistry KB, McRae A .
"It makes me a better person and doctor": a qualitative study of residents' perceptions of a curriculum addressing racism.
Acad Pediatr 2022 Mar;22(2):332-41. doi: 10.1016/j.acap.2021.12.012..
Keywords:
Education: Curriculum, Education: Continuing Medical Education, Racial / Ethnic Minorities, Provider: Physician
Riviello ED, Dechen T, O'Donoghue AL
Assessment of a crisis standards of care scoring system for resource prioritization and estimated excess mortality by race, ethnicity, and socially vulnerable area during a regional surge in COVID-19.
Researchers analyzed the association of a crisis standards of care (CSOC) scoring system with resource prioritization and estimated excess mortality by race, ethnicity, and residence in a socially vulnerable area during the COVID-19 pandemic. Using data from 6 hospitals in greater Boston, Massachusetts, they found that a CSOC priority score resulted in lower prioritization of Black patients to receive scarce resources. Also, a model using a random lottery resulted in more estimated excess deaths overall without improving equity by race.
AHRQ-funded; HS024288.
Citation:
Riviello ED, Dechen T, O'Donoghue AL .
Assessment of a crisis standards of care scoring system for resource prioritization and estimated excess mortality by race, ethnicity, and socially vulnerable area during a regional surge in COVID-19.
JAMA Netw Open 2022 Mar;5(3):e221744. doi: 10.1001/jamanetworkopen.2022.1744..
Keywords:
COVID-19, Racial / Ethnic Minorities, Mortality, Public Health, Vulnerable Populations
Fernandez JR, Richmond J, Nápoles AM
Everyday discrimination and cancer metaphor preferences: the mediating effects of needs for personal significance and cognitive closure.
This study examined the relationship between discrimination and preferences for cancer battle metaphors versus journey metaphors. Four-hundred twenty-seven cancer patients completed an online survey. Question items included on every day discrimination, need for personal significance, need for cognitive closure, and preference for cancer scenarios using battle or journey metaphors. Discrimination was associated with battle metaphor preferences through serial mediation when discrimination was not associated to race. When discrimination was associated with race, it was directly associated with journey metaphor preferences and the serial medication was nonsignificant. The single mediation model was strongest for non-Hispanic White participants and varied across racial/ethnic groups.
AHRQ-funded; HS026122.
Citation:
Fernandez JR, Richmond J, Nápoles AM .
Everyday discrimination and cancer metaphor preferences: the mediating effects of needs for personal significance and cognitive closure.
SSM Popul Health 2022 Mar;17:100991. doi: 10.1016/j.ssmph.2021.100991..
Keywords:
Cancer, Racial / Ethnic Minorities
Van Gerwen OT, Talluri R, Camino AF
Human immunodeficiency virus/sexually transmitted infection testing preferences for young Black men who have sex with men in the Southeastern United States: implications for a post-COVID-19 era.
Study researchers used a discrete choice experiment to assess the preferences of Young Black Men Who Have Sex with Men (YBMSM) in the Southeastern U.S. regarding their preferences for human immunodeficiency virus (HIV)/ sexually transmitted infection (STI) testing locations, staffing, cost, and hours of operation. Between June 2018 and December 2019, 213 YBMSM between the ages of 16-35 years, located in Birmingham, Alabama and Jackson, Mississippi completed online surveys evaluating their preferences. Traditional, stationary testing locations were preferred by both groups over mobile testing vans. The most significant difference in preference was for local health departments in Alabama, and STI testing-only clinics in Mississippi. Both groups preferred clinician-performed testing over technician-performed testing or self-testing, with additional preferences for free testing and phone results notification (versus text). The most preferred combination among all participants was the $5 clinician-performed testing at the health department. The study concluded that YBMSM in the Southeastern United States prefer traditional testing locations staffed by experienced personnel. The study researchers advise that more research is needed to inform the best ways to approach HIV/STI testing services for YBMSM, especially in the post-COVID-19 era when delivery models are shifting toward health-focused strategies which are home-based and remote.
AHRQ-funded; HS013852.
Citation:
Van Gerwen OT, Talluri R, Camino AF .
Human immunodeficiency virus/sexually transmitted infection testing preferences for young Black men who have sex with men in the Southeastern United States: implications for a post-COVID-19 era.
Sex Transm Dis 2022 Mar;49(3):208-15. doi: 10.1097/olq.0000000000001559..
Keywords:
COVID-19, Human Immunodeficiency Virus (HIV), Infectious Diseases, Racial / Ethnic Minorities, Men's Health
Johnson TJ, Goyal MK, Lorch SA
Racial/ethnic differences in pediatric emergency department wait times.
The authors sought to determine whether racial/ethnic differences exist in wait times for children presenting to pediatric emergency departments (PEDs) and to examine between-site and within-site differences. They found that median wait time was 35 minutes. Further, in unadjusted analyses, non-White children experienced longer PED wait times than non-Hispanic White (NHW) children. After adjusting for illness severity, patient demographics, and overcrowding measures, wait times for non-Hispanic Black and other race children were largely determined by site of care. Hispanic children experienced longer within-site and between-site wait times compared with NHW children.
AHRQ-funded; HS020270.
Citation:
Johnson TJ, Goyal MK, Lorch SA .
Racial/ethnic differences in pediatric emergency department wait times.
Pediatr Emerg Care 2022 Feb;38(2):e929-e35. doi: 10.1097/pec.0000000000002483..
Keywords:
Children/Adolescents, Emergency Department, Racial / Ethnic Minorities
Steinberg RS, Nayak A, Burke MA
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Caregiver support is considered necessary after heart transplant (HT) and left ventricular assist device (LVAD) for patients with end-stage heart failure (HF). Few studies have demonstrated how caregivers differ by gender and race, and whether that impacts therapy eligibility. In this study, the investigators examined caregiver relationships among 674 patients (32% women, 55% Black) evaluated at Emory University from 2011 to 2017.
AHRQ-funded; HS026081.
Citation:
Steinberg RS, Nayak A, Burke MA .
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Clin Transplant 2022 Jan;36(1):e14502. doi: 10.1111/ctr.14502..
Keywords:
Caregiving, Racial / Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions
Carroll AR, Hall M, Brown CM
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
This retrospective cohort study evaluated the associations of race/ethnicity and social determinants with 90-day rehospitalization of children with mental health conditions to acute non-psychiatric children’s hospitals. Children included were aged 5 to 18 years at 32 freestanding U.S. children’s hospitals from 2016-2018 using the Children’s Hospital Association’s Pediatric Health Information System (PHIS) database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Among 23,556 index hospitalizations, 5.9% (n = 1382) were rehospitalized for mental health within 90 days. Non-Hispanic Black children were 26% more likely to be rehospitalized than non-Hispanic White children. Those with government insurance were 18% more likely to rehospitalized than those with private insurance. Those living in a suburban location were 22% less likely to be rehospitalized than those living in an urban location.
AHRQ-funded; HS026122.
Citation:
Carroll AR, Hall M, Brown CM .
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
J Pediatr 2022 Jan;240:228-34.e1. doi: 10.1016/j.jpeds.2021.08.078..
Keywords:
Children/Adolescents, Hospital Readmissions, Behavioral Health, Social Determinants of Health, Racial / Ethnic Minorities
Akingbade O, Peek ME, Tung EL. O, Peek ME, Tung EL
Network size or proximity? Association of network characteristics with violence-related stress and PTSD among racial/ethnic minorities in Chicago.
This research brief examined the association of network size compared to network size and proximity and the psychosocial health and PTSD rates among high-risk racial/ethnic minorities in two Chicago neighborhoods. A sample of 504 adults were surveyed from one South and one West side Chicago clinic in 2018. Only participants who self-reported lifetime exposure in the Brief Trauma Questionnaire to community violence were included, decreasing the sample size to 297. The majority of participants were female (69%) and non-Hispanic Black (75%). Two-thirds were direct victims of robbery or assault, and one-third tested positive for PTSD. Median number of network confidants was found to be 2. A larger network size (> 3 confidants) within 30 minutes from home was significantly associated with 67% lower adjusted odds of PTSD compared to those with no confidants within 30 minutes from home.
AHRQ-funded; HS023007.
Citation:
Akingbade O, Peek ME, Tung EL. O, Peek ME, Tung EL .
Network size or proximity? Association of network characteristics with violence-related stress and PTSD among racial/ethnic minorities in Chicago.
J Gen Intern Med 2022 Jan;37(1):255-57. doi: 10.1007/s11606-021-06607-w..
Keywords:
Behavioral Health, Racial / Ethnic Minorities, Stress, Domestic Violence
Lin JS, Hoffman L, Bean SI
Addressing racism in preventive services: methods report to support the US Preventive Services Task Force.
The purpose of this report was to articulate the definitional and conceptual issues around racism and health inequity and to describe how racism and health inequities are currently addressed in preventive health. An audit was conducted assessing published literature on policy and position statements addressing racism, a subset of cancer and cardiovascular topics in USPSTF reports, recent systematic reviews on interventions to reduce health inequities, and societies, organizations, agencies, and funding bodies to gather information about how they address racism and health equity. Findings showed that racism is complex and pervasive, operates at multiple interrelated levels, and exerts negative effects on other social determinants and health and well-being through multiple pathways. The most directly relevant and immediately useful guidance identified is that from the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group.
AHRQ-funded; 290201600006C.
Citation:
Lin JS, Hoffman L, Bean SI .
Addressing racism in preventive services: methods report to support the US Preventive Services Task Force.
JAMA 2021 Dec 21;326(23):2412-20. doi: 10.1001/jama.2021.17579..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Social Determinants of Health, Racial / Ethnic Minorities, Disparities, Research Methodologies, Prevention, Evidence-Based Practice
Admon LK, Dalton VK, Kolenic GE
Comparison of delivery-related, early and late postpartum severe maternal morbidity among individuals with commercial insurance in the US, 2016 to 2017.
This study analyzed data from 2016 to 2017 on delivery-related, early, and late postpartum severe maternal morbidity (SMM) among individuals with commercial insurance by race and ethnicity and perinatal mood and anxiety disorder (PMAD) status. This cross-sectional study of deidentified claims data from the Optum Clinformatics Data Mart evaluated rates of SMM during 3 pregnancy periods among individuals aged 15 to 44 years. The study sample comprised of 100,982 individuals with a mean age of 31.6 years. SMM rates were compared for pregnancies with and without complications, with blood transfusions being the number one indicator for pregnancy and postpartum periods with SMM. Rates of SMM with and without blood transfusion varied by race and ethnicity and PMAD status. Higher rates of SMM were identified among Black individuals compared with White individuals for the pregnancy, early postpartum, and late postpartum periods, respectively. Higher rates of blood transfusion were also identified in each of the 3 periods among individuals with PMADs compared to individuals without PMADs.
AHRQ-funded; HS027640.
Citation:
Admon LK, Dalton VK, Kolenic GE .
Comparison of delivery-related, early and late postpartum severe maternal morbidity among individuals with commercial insurance in the US, 2016 to 2017.
JAMA Netw Open 2021 Dec;4(12):e2137716. doi: 10.1001/jamanetworkopen.2021.37716..
Keywords:
Labor and Delivery, Pregnancy, Maternal Care, Pregnancy, Health Insurance, Racial / Ethnic Minorities, Anxiety
Fashaw-Walters SA, McCreedy E, Bynum JPW
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
Investigators examined how race and Alzheimer's and related dementia (ADRD) status influenced the rate of schizophrenia diagnoses among nursing home (NH) residents following the CMS National Partnership to Improve Dementia Care. Using 2011-2015 Minimum Data Set 3.0 assessments, they found that, following the partnership, black NH residents with ADRD were more likely to have a schizophrenia diagnosis documented on their minimum data set assessments, and schizophrenia rates increased for black NH residents with ADRD only.
AHRQ-funded; HS000011.
Citation:
Fashaw-Walters SA, McCreedy E, Bynum JPW .
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
J Am Geriatr Soc 2021 Dec;69(12):3623-30. doi: 10.1111/jgs.17464..
Keywords:
Elderly, Dementia, Nursing Homes, Racial / Ethnic Minorities, Long-Term Care
Valdovinos C, Perez-Aguilar G, Huerta RG
Electronic health literacy among linguistically diverse patients in the Los Angeles County safety net health system.
Few studies have been conducted which evaluate levels of eHealth literacy in underserved populations, yet eHealth literacy may affect telehealth utilization. The objective of this study was to describe eHealth literacy levels as well as technology use and access patterns among English-speaking and Limited English Proficiency (LEP) patients from three Los Angeles clinics for uninsured, Medicaid, and other vulnerable patients (“safety-net” clinics). Between June and July of 2017, patients aged 18 or over with diabetes mellitus and/ or hypertension and their caregivers were recruited for the study. The researchers asked both English-speaking and LEP Spanish-speaking patients about their technology use and access, and assessed their levels of health literacy using the eHealth Literacy Scale (eHeals). A total of 62 patients and 9 caregivers, with a mean age of 56, completed the questionnaire. The study found that 67% of participants used a telephone that had internet access. For the 10 items on the eHEALS instrument, the mean score was in the moderate range at 26/50 points. There was no difference in the mean eHEALS score between the English-speaking and LEP Spanish speaking groups, however 68% of English-speaking participants “agreed/ strongly agreed” that they knew how to use the internet to answer their health questions, compared to 47% of the Spanish-speaking participants (P<.05). The study concluded that despite moderate levels of electronic health literacy, participant’s perceived confidence and skills in engaging with electronic health systems were low.
AHRQ-funded; HS026407.
Citation:
Valdovinos C, Perez-Aguilar G, Huerta RG .
Electronic health literacy among linguistically diverse patients in the Los Angeles County safety net health system.
Ethn Dis 2022 Winter;32(1):21-30. doi: 10.18865/ed.32.1.21..
Keywords:
Health Literacy, Health Information Technology (HIT), Racial / Ethnic Minorities, Safety Net
Ejem D, Steinhauser K, Dionne-Odom JN
Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians.
This study explored how religion and spirituality (R/S) impacts the ways that African Americans (AAs) cope with serious illness. In particular, this study looks at AAs with advanced heart failure and their family caregivers’ (FCGs) preferences about R/S in patient-clinician communication. Transcribed interviews were analyzed to identify emergent themes. AA patient participants (n = 15) were a mean age of 62, 40% female, and 87% had >high school diploma/GED. AA FCGs (n = 14) were a mean age of 58, 93% female, 93% had >high school diploma/GED, and 86% were unemployed. Most caregivers were patients’ spouses/partners. All participants were Protestants. Patients and FCGs perspectives differed in relation to inclusion of R/S in health care communication. Patients felt that R/S should not be discussed in clinical encounters and discussed only if patient initiated. FCGs felt that clinicians’ R/S communication is not a priority, but clinicians should openly acknowledge patients’ R/S beliefs and should engage in R/S conversations with patients.
AHRQ-funded; HS013852.
Citation:
Ejem D, Steinhauser K, Dionne-Odom JN .
Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians.
J Palliat Med 2021 Dec;24(12):1798-806. doi: 10.1089/jpm.2021.0044..
Keywords:
Racial / Ethnic Minorities, Communication, Heart Disease and Health, Cardiovascular Conditions, Caregiving
Werner RM, Templeton Z, Apathy N
Trends in post-acute care in US nursing homes: 2001-2017.
The purpose of this retrospective cohort study was to describe recent trends in post-acute care provision within nursing homes, focusing specifically on nursing homes' degree of specialization in post-acute care. The investigators concluded that over the last 2 decades, post-acute care has become increasingly concentrated in a subset of nursing homes, which tend to be for-profit, part of a chain, and less likely to serve racial and ethnic minorities and persons on Medicaid.
AHRQ-funded; HS026116.
Citation:
Werner RM, Templeton Z, Apathy N .
Trends in post-acute care in US nursing homes: 2001-2017.
J Am Med Dir Assoc 2021 Dec;22(12):2491-95.e2. doi: 10.1016/j.jamda.2021.06.015..
Keywords:
Elderly, Nursing Homes, Racial / Ethnic Minorities
Protudjer JLP, Greenhawt M, Abrams EM
Race and ethnicity and food allergy: remaining challenges.
Food allergy is a common chronic condition of childhood, with an increasing prevalence over time. Similar to other chronic pediatric diseases, the burden of disease falls most heavily among historically underrepresented racial and ethnic populations. This article examines challenges related to race, ethnicity and food allergy.
AHRQ-funded; HS024599.
Citation:
Protudjer JLP, Greenhawt M, Abrams EM .
Race and ethnicity and food allergy: remaining challenges.
J Allergy Clin Immunol Pract 2021 Nov;9(11):3859-61. doi: 10.1016/j.jaip.2021.07.004..
Keywords:
Chronic Conditions, Racial / Ethnic Minorities
Gorman DC, Ham SA, Staab EM
Medical assistant protocol improves disparities in depression screening rates.
This study examined the impacts of a medical assistant screening protocol on the rates of depression screening, overall and by sociodemographic groups, in a primary care setting. Findings showed that implementation of a medical assistant protocol in a primary care setting may significantly increase depression screening rates while mitigating or removing sociodemographic disparities.
AHRQ-funded; HS026151.
Citation:
Gorman DC, Ham SA, Staab EM .
Medical assistant protocol improves disparities in depression screening rates.
Am J Prev Med 2021 Nov;61(5):692-700. doi: 10.1016/j.amepre.2021.05.010..
Keywords:
Disparities, Depression, Behavioral Health, Screening, Racial / Ethnic Minorities
Ingraham NE, Purcell LN, Karam BS
Racial and ethnic disparities in hospital admissions from COVID-19: determining the impact of neighborhood deprivation and primary language.
This retrospective cohort study evaluated neighborhood-level deprivation and English language proficiency effects on disproportionate outcomes seen in racial and ethnic minorities diagnosed with COVID-19. Health records of 12 Midwest hospitals and 60 clinics in Minnesota between March 4 and August 19, 2020 were used. COVID-19 hospitalization rates were evaluated against the patient’s Area Deprivation Index (ADI) and primary language. A total of 5577 individuals were included, with 866 hospitalized within 45 days of diagnosis. Hospitalized patients were older, and more likely to be male. Minority/race ethnicity was associated with COVID-19 severity, but ADI was not associated with increased hospitalization. Non-English speaking significantly increased odds of hospital admission across and within minority groups.
AHRQ-funded; HS024532; HS26732; HS026379.
Citation:
Ingraham NE, Purcell LN, Karam BS .
Racial and ethnic disparities in hospital admissions from COVID-19: determining the impact of neighborhood deprivation and primary language.
J Gen Intern Med 2021 Nov;36(11):3462-70. doi: 10.1007/s11606-021-06790-w..
Keywords:
COVID-19, Hospitalization, Racial / Ethnic Minorities, Disparities
Goyal MK, Drendel AL, Chamberlain JM
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
The purpose of this study was to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have decreased over time. Findings showed that, as provision of opioid prescriptions declined over time, previously marked racial and/or ethnic disparities in opioid
prescription rates at ED discharge decreased.
prescription rates at ED discharge decreased.
AHRQ-funded; HS020270.
Citation:
Goyal MK, Drendel AL, Chamberlain JM .
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
Pediatrics 2021 Nov;148(5):e2021052481. doi: 10.1542/peds.2021-052481..
Keywords:
Children/Adolescents, Opioids, Emergency Department, Racial / Ethnic Minorities, Injuries and Wounds, Pain, Medication
Herb J, Staley BS, Roberson M
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
The investigators’ objective was to determine national usage and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism among insured older adults. Data was obtained using Medicare claims. They found that parathyroidectomy was underused and recommended that quality improvement efforts, rooted in equitable care, be undertaken to increase access to parathyroidectomy for this disease.
AHRQ-funded; HS000032.
Citation:
Herb J, Staley BS, Roberson M .
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
Surgery 2021 Nov;170(5):1376-82. doi: 10.1016/j.surg.2021.05.026..
Keywords:
Elderly, Disparities, Medicare, Surgery, Racial / Ethnic Minorities
Thompson HM, Sharma B, Bhalla S
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
The objective of this study was to assess fairness and bias of a previously validated machine learning opioid misuse classifier. Two experiments were conducted with the classifier's original and external validation datasets from 2 health systems. Bias was assessed via testing for differences in type II error rates across racial/ethnic subgroups (Black, Hispanic/Latinx, White, Other) using bootstrapped 95% confidence intervals. The investigators concluded that standardized, transparent bias assessments were needed to improve trustworthiness in clinical machine learning models.
AHRQ-funded; HS026385.
Citation:
Thompson HM, Sharma B, Bhalla S .
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
J Am Med Inform Assoc 2021 Oct 12;28(11):2393-403. doi: 10.1093/jamia/ocab148..
Keywords:
Opioids, Substance Abuse, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial / Ethnic Minorities
Grafova IB, Jarrín OF
Beyond Black and White: mapping misclassification of Medicare beneficiaries race and ethnicity.
This study examined state-level variation in racial/ethnic misclassification of race and ethnicity in the Centers for Medicare and Medicaid Services administrative database using the enrollment database (EDB) beneficiary race code and the Research Triangle Institute (RTI) race code. The cohort included 4,231,370 Medicare beneficiaries who utilized home health care services in 2015. The authors found substantial variation between states in misclassification of self-identified Hispanic, Asian American/Pacific Islander, and American Indian/Alaska Native beneficiaries.
AHRQ-funded; HS022406.
Citation:
Grafova IB, Jarrín OF .
Beyond Black and White: mapping misclassification of Medicare beneficiaries race and ethnicity.
Med Care Res Rev 2021 Oct;78(5):616-26. doi: 10.1177/1077558720935733..
Keywords:
Medicare, Racial / Ethnic Minorities, Disparities
Nguyen KH, Thorsness R, Hayes S
Evaluation of racial, ethnic, and socioeconomic disparities in initiation of kidney failure treatment during the first 4 months of the COVID-19 pandemic.
This study examined the impact of COVID-19 on initiation of kidney failure treatment during the first 4 months of the pandemic with a focus on racial, ethnic, and socioeconomic disparities. The study population included 127,149 patients with incident kidney failure between January 2018 and June 2020. The mean age of patients was 62.8 years, and were 41.7% female, 25.9% non-Hispanic Black and 15.6% Hispanic/Latino. There were significant decreases in the proportion of patients with incident kidney failure receiving preemptive transplantation and initiating hemodialysis treatment with an arteriovenous fistula during the first 4 months of the pandemic compared to the pre-COVID-19 period. These decreases were most significant among non-Hispanic Black patients. There were also significant decreases in patients residing in counties in the highest quintile of COVID-19 mortality rates, but not for patients residing in other counties. Treatment initiation was approximately 30% lower than projected in April 2020.
AHRQ-funded; HS028285.
Citation:
Nguyen KH, Thorsness R, Hayes S .
Evaluation of racial, ethnic, and socioeconomic disparities in initiation of kidney failure treatment during the first 4 months of the COVID-19 pandemic.
JAMA Netw Open 2021 Oct;4(10):e2127369. doi: 10.1001/jamanetworkopen.2021.27369..
Keywords:
COVID-19, Kidney Disease and Health, Racial / Ethnic Minorities, Disparities
Valbuena VSM, Obayemi JE, Purnell TS
Gender and racial disparities in the transplant surgery workforce.
This review explores trends in the United States (US) transplant surgery workforce with a focus on historical demographics, post-fellowship job market, and quality of life reported by transplant surgeons. Ongoing efforts to improve women and racial/ethnic minority representation in transplant surgery are highlighted in this paper. Future directions to create a transplant workforce that reflects the diversity of the US population are discussed.
AHRQ-funded; HS024600; HS000053.
Citation:
Valbuena VSM, Obayemi JE, Purnell TS .
Gender and racial disparities in the transplant surgery workforce.
Curr Opin Organ Transplant 2021 Oct 1;26(5):560-66. doi: 10.1097/mot.0000000000000915..
Keywords:
Workforce, Provider: Physician, Transplantation, Racial / Ethnic Minorities
