ArticleJournal of medical systems2021
Sensitivity and Specificity of Real-World Social Factor Screening Approaches.
Article in Journal of medical systems, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Paradoxes of Social Care: Reframing Apparent Conflicts.Annals of family medicine · 2026Pooled it
- Association of Socioeconomic Risk Factors of Food Insecurity With Post-abdominal Surgery Complications in the USA.Cureus · 2026Article
- Article
- Housing Insecurity, Behavioral Health Disorders, and Acute Care Utilization: A Cross-Sectional Study of Medicaid Members in the Portland, Oregon Metropolitan Area.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Clinical Note-Extracted Psychosocial Factors for Predicting Suicide Attempt Among ED Patients With Suicidal Ideation.JAMA network open · 2026Article
- Prenatal homelessness, food insecurity, and unemployment and adverse infant outcomes in a California cohort, 2007-2020.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Insurance Type and Social Determinants of Health for Individuals Seeking Gender-Affirming Care in the United States.Journal of general internal medicine · 2025Article
- Physical Restraint Use in Hospitalized Patients: A Study of Routinely Collected Health Records Data.Journal of general internal medicine · 2025Article
- Article
- Development and validation of computable social phenotypes for health-related social needs.JAMIA open · 2025Article
- Food Insecurity Screening in High-Income Countries, Tool Validity, and Implementation: A Scoping Review.Nutrients · 2024Article
- Prehospital Care for Persons Experiencing Homelessness: A Cross-Sectional Survey of the Challenges, Experiences, and Perspectives of Operational EMS Agency Medical Directors.Prehospital emergency care · 2024Article
- Neighborhood social deprivation and healthcare utilization, disability, and comorbidities among young adults with congenital heart defects: Congenital heart survey to recognize outcomes, needs, and well-being 2016-2019.Birth defects research · 2023Article
- Health-Related Social Needs: Which Patients Respond to Screening and Who Receives Resources?Journal of general internal medicine · 2023Observational
- Automatic extraction of social determinants of health from medical notes of chronic lower back pain patients.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Social Determinants of Health-Related Z Codes and Health Care Among Patients With Hypertension.AJPM focus · 2023Article
- Association of Coded Housing Instability and Hospitalization in the US.JAMA network open · 2022Article
- Z-Coding for Social Contributors to Health in Colorado Federally Qualified Health Centers.Nursing researchArticle
- The Association Between Patient-Reported Social Risks and the HOUSES Index: A Rural-Urban Comparison.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Health care organizations are increasingly documenting patients for social risk factors in structured data. Two main approaches to documentation, ICD-10 Z codes and screening questions, face limited adoption and conceptual challenges. This study compared estimates of social risk factors obtained via screening questions and ICD-10 Z diagnoses coding, as used in clinical practice, to estiamtes from validated survey instruments in a sample of adult primary care and emergency department patients at an urban safety-net health system. Financial strain, transportation barriers, food insecurity, and housing instability were independently assessed using instruments with published reliability and validity. These four social factors were also being collected by the health system in screening questions or could be mapped to ICD-10 Z code diagnosis code concepts. Neither the screening questions nor ICD-10 Z codes performed particularly well in terms of accuracy. For the screening questions, the Area Under the Curve (AUC) scores were 0.609 for financial strain, 0.703 for transportation, 0.698 for food insecurity, and 0.714 for housing instability. For the ICD-10 Z codes, AUC scores tended to be lower in the range of 0.523 to 0.535. For both screening questions and ICD-10 Z codes, the measures were much more specific than sensitive. Under real world conditions, ICD-10 Z codes and screening questions are at the minimal, or below, threshold for being diagnostically useful approaches to identifying patients' social risk factors. Data collection support through information technology or novel approaches combining data sources may be necessary to improve the usefulness of these data.
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