Trial reportJournal of acquired immune deficiency syndromes (1999)2019
Clinical and Sociobehavioral Prediction Model of 30-Day Hospital Readmissions Among People With HIV and Substance Use Disorder: Beyond Electronic Health Record Data.
Trial report in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Social determinants of health in electronic health records and their impact on analysis and risk prediction: A systematic review.Journal of the American Medical Informatics Association : JAMIA · 2020Pooled it
- Article
- Changes in the Prevalence of Non-AIDS Conditions Among Hospitalized Persons With HIV in the United States and Canada, 2008-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Synth-SBDH: A Synthetic Dataset of Social and Behavioral Determinants of Health for Clinical Text.Proceedings of the Conference on Empirical Methods in Natural Language Processing. Conference on Empirical Methods in Natural Language Processing · 2025Article
- Article
- Identifying and Addressing Social Determinants of Health with an Electronic Health Record.Journal of the American Board of Family Medicine : JABFM · 2025Observational
- Perspectives on Using Artificial Intelligence to Derive Social Determinants of Health Data From Medical Records in Canada: Large Multijurisdictional Qualitative Study.Journal of medical Internet research · 2025Article
- Article
- Impact of hospital and health system initiatives to address Social Determinants of Health (SDOH) in the United States: a scoping review of the peer-reviewed literature.BMC health services research · 2025Article
- Model-based estimation of individual-level social determinants of health and its applications in All of Us.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Social determinants of health and sepsis: a case-control study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- Question-answering system extracts information on injection drug use from clinical notes.Communications medicine · 2024Article
- Realizing the potential of social determinants data in EHR systems: A scoping review of approaches for screening, linkage, extraction, analysis, and interventions.Journal of clinical and translational science · 2024Article
- Clinic-level complexities prevent effective engagement of people living with HIV who are out-of-care.PloS one · 2024Article
- Characteristics of hospital and health system initiatives to address social determinants of health in the United States: a scoping review of the peer-reviewed literature.Frontiers in public health · 2024Article
- Hospital Readmissions Among Persons With Human Immunodeficiency Virus in the United States and Canada, 2005-2018: A Collaboration of Cohort Studies.The Journal of infectious diseases · 2023Article
- Screening for poverty and related social determinants to improve knowledge of and links to resources (SPARK): development and cognitive testing of a tool for primary care.BMC primary care · 2023Article
- Leveraging natural language processing to augment structured social determinants of health data in the electronic health record.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Man vs. Machine: Comparing Physician vs. Electronic Health Record-Based Model Predictions for 30-Day Hospital Readmissions.Journal of general internal medicine · 2021Article
- MIMIC-SBDH: A Dataset for Social and Behavioral Determinants of Health.Proceedings of machine learning research · 2021Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundUnder the Affordable Care Act, hospitals receive reduced reimbursements for excessive 30-day readmissions. However, the Centers for Medicare and Medicaid Services does not consider social and behavioral variables in expected readmission rate calculations, which may unfairly penalize systems caring for socially disadvantaged patients, including patients with HIV.
settingRandomized controlled trial of patient navigation with or without financial incentives in HIV-positive substance users recruited from the inpatient setting at 11 US hospitals.
methodsExternal validation of an existing 30-day readmission prediction model, using variables available in the electronic health record (EHR-only model), in a new multicenter cohort of HIV-positive substance users was assessed by C-statistic and Hosmer-Lemeshow testing. A second model evaluated sociobehavioral factors in improving the prediction model (EHR-plus model) using multivariable regression and C-statistic with cross-validation.
resultsThe mean age of the cohort was 44.1 years, and participants were predominantly males (67.4%), non-white (88.0%), and poor (62.8%, <$20,000/year). Overall, 17.5% individuals had a hospital readmission within 30 days of initial hospital discharge. The EHR-only model resulted in a C-statistic of 0.65 (95% confidence interval: 0.60 to 0.70). Inclusion of additional sociobehavioral variables, food insecurity and readiness for substance use treatment, in the EHR-plus model resulted in a C-statistic of 0.74 (0.71 after cross-validation, 95% confidence interval: 0.64 to 0.77).
conclusionsIncorporation of detailed social and behavioral variables substantially improved the performance of a 30-day readmission prediction model for hospitalized HIV-positive substance users. Our findings highlight the importance of social determinants in readmission risk and the need to ask about, adjust for, and address them.
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