An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support
An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support
批准号:
10643952
负责人:
CANDYCE H KROENKE
金额:
$0.0万
依托单位国家:
美国
项目类别:
财政年份:
2020
资助国家:
美国
项目状态:
未结题
起止时间:
2020-09-01 至 2026-05-31
关键词:
AcademyAddressAfrican AmericanAreaAsianBlack raceBreast Cancer PatientBreast Cancer TreatmentCaliforniaCancer Research NetworkCaringClinicalCodeCohort StudiesDataData CollectionDevelopmentDiagnosisDocumentationElectronic Health RecordEmergency SituationEthnic OriginEthnic PopulationFundingHealthHealthcare SystemsHispanicInformation TechnologyInterventionLanguageLinear RegressionsLinkLiteratureLogistic RegressionsLogisticsMarital StatusMeasuresMedicalMedical Care TeamMedical RecordsMedicineMinority WomenNatural Language ProcessingNewly DiagnosedNot Hispanic or LatinoOperative Surgical ProceduresOutcomePacific IslanderPathway interactionsPatient riskPatient-Focused OutcomesPatientsPerceptionPilot ProjectsPopulationProviderPublishingQuestionnairesROC CurveRaceRecommendationResearchResearch PersonnelResourcesRiskServicesSocial ConditionsSocial NetworkSocial supportSourceStructureTextTreatment outcomeWomanWorkanalytical methodanticancer researchcancer carecancer health disparitychemotherapyclinical careclinically relevantcohortethnic disparityethnic diversityethnic minorityhazardhealth care settingshigh riskhormone therapyimprovedimproved outcomemalignant breast neoplasmmortalitypatient responseracial disparityracial diversityracial minorityracial populationsocialsocial computingsocial health determinantssocial relationshipssocial structurestructured datatheoriestooltreatment and outcomeunstructured data
中文摘要
摘要
英文摘要
ABSTRACT
Social support, a social determinant of health (SDoH), is a definitive predictor of breast cancer (BC) treatment
and mortality outcomes. Because of the recognition that social support is critical to BC patient outcomes,
clinicians within Kaiser Permanente Northern California (KPNC) have documented information on social
support in the electronic health record (EHR) since the advent of Epic in 2005. However, no EHR-based social
support measure currently exists to help clinicians identify patients at high risk of low social support. Such a
measure has high relevance for addressing racial/ethnic disparities in BC treatment and outcomes. Therefore,
we propose to develop an Electronic Health Record Social Support Patient Risk Tool (EHR-SUPPORT) that
could be used to identify women with BC at risk of low social support for referral to social support resources.
We propose to: 1) Identify terms in the EHR, based on theory and prior literature, and informed by KPNC
stakeholders in BC care, that reflect structural and/or functional social support, and have been associated with
BC treatment and outcomes; 2) Develop EHR-SUPPORT, using structured, semi-structured, and unstructured
data (to include natural language processing of text) that identifies patients at risk of low social support, overall
and by race/ethnicity, and validate the measure against published social support measures; and 3) Evaluate
associations of EHR-SUPPORT and its component variables with BC treatment (surgery and chemotherapy
delays, nonadherence to hormonal therapy) and BC-specific and total mortality, overall and by race/ethnicity in
44,348 women diagnosed with stage I-IV BC within Kaiser Permanente Northern California between 2006-
2023 including 3,450 Black, 4,441 Hispanic, 6,571 Asian women, and 28,589 non-Latina white women. In an
exploratory aim, we will develop, with KP clinician stakeholders, steps to the implementation of EHR-
SUPPORT. We will review 100 medical records (25 in each race/ethnic group) within two months of diagnosis,
informed by investigator expertise and clinician stakeholders, to develop terms used to describe patient
support. In addition to developing structured data, we will use natural language processing of text fields to
further develop social support indicators (Aim 1). EHR-SUPPORT will be computed from social support
indicators; we will use linear and logistic regression to validate the developed measure against established
social support measures in Pathways, a well-established cohort of 4,505 women with BC and use factor
analytic and confirmatory factor analytic methods as well as ROC curves to further evaluate the score (Aim 2).
We will use linear, logistic, and Cox proportional hazards regression to evaluate associations in Aim 3. The
unique convergence of EHR and cohort data provides the first opportunity to develop and validate an EHR-
based social support measure in in diverse women with BC, adjusted for an extensive set of covariates. This
work is central to identifying patients at elevated risk of low social support and to enhancing social support-
cancer research needed to improve clinical care and reduce BC disparities.
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DOI:
10.1089/pop.2023.0171
发表时间:
2023-12-01
期刊:
POPULATION HEALTH MANAGEMENT
影响因子:
2.5
作者:
[Mosen,David M., Banegas,Matthew P., Dickerson,John F.]
通讯作者:
Dickerson,John F.
Impact of Racial/Ethnic Discrimination on Quality of Life Among Breast Cancer Survivors.
种族/民族歧视对乳腺癌幸存者生活质量的影响。
DOI:
10.1093/aje/kwac208
发表时间:
2023
期刊:
American journal of epidemiology
影响因子:
5
作者:
[Shariff-Marco,Salma, Sangaramoorthy,Meera, Ellis,Libby, Thomsen,Catherine, Roh,JaniseM, Kroenke,Candyce, Valice,Emily, Kwan,MarilynL, Ambrosone,Christine, Kushi,Lawrence, Gomez,ScarlettLin]
通讯作者:
Gomez,ScarlettLin
DOI:
10.1007/s10389-020-01342-8
发表时间:
2022-04
期刊:
Zeitschrift fur Gesundheitswissenschaften = Journal of public health
影响因子:
--
作者:
[]
通讯作者:
DOI:
10.1161/jaha.120.022907
发表时间:
2022-03
期刊:
JOURNAL OF THE AMERICAN HEART ASSOCIATION
影响因子:
5.4
作者:
[Cene, Crystal W., Leng, Xiaoyan Iris, Faraz, Khushnood, Allison, Matthew, Breathett, Khadijah, Bird, Chloe, Coday, Mace, Corbie-Smith, Giselle, Foraker, Randi, Ijioma, Nkechinyere N., Rosal, Milagros C., Sealy-Jefferson, Shawnita, Shippee, Tetyana P., Kroenke, Candyce H.]
通讯作者:
Kroenke, Candyce H.
DOI:
10.1093/gerona/glab371
发表时间:
2022-12-06
期刊:
The journals of gerontology. Series A, Biological sciences and medical sciences
影响因子:
--
作者:
[Goveas JS, Ray RM, Woods NF, Manson JE, Kroenke CH, Michael YL, Shadyab AH, Meliker JR, Chen JC, Johnson L, Mouton C, Saquib N, Weitlauf J, Wactawski-Wende J, Naughton M, Shumaker S, Anderson GL]
通讯作者:
Anderson GL
共 9 条
An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support
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批准号:10245056
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项目类别:
-
资助金额:$61.5万
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财政年份:2020
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负责人:CANDYCE H KROENKE
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依托单位:
An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support
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批准号:10047252
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项目类别:
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资助金额:$58.57万
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财政年份:2020
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负责人:CANDYCE H KROENKE
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依托单位:
An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support
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批准号:10408831
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项目类别:
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资助金额:$53.83万
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财政年份:2020
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负责人:CANDYCE H KROENKE
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依托单位:
Social networks and disparities in health behaviors and breast cancer outcomes in immigrant women
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批准号:10203873
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项目类别:
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资助金额:$67.0万
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财政年份:2019
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负责人:CANDYCE H KROENKE
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依托单位:
Social networks and disparities in health behaviors and breast cancer outcomes in immigrant women
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批准号:9899953
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项目类别:
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资助金额:$64.58万
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财政年份:2019
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负责人:CANDYCE H KROENKE
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依托单位:
Social networks and disparities in health behaviors and breast cancer outcomes in immigrant women
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批准号:10454120
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项目类别:
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资助金额:$65.66万
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财政年份:2019
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负责人:CANDYCE H KROENKE
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依托单位:
Social networks, breast cancer treatment, and survival
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批准号:8968175
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项目类别:
-
资助金额:$18.69万
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财政年份:2015
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负责人:CANDYCE H KROENKE
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依托单位:
Social networks, breast cancer treatment, and survival
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批准号:9314444
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项目类别:
-
资助金额:$18.69万
-
财政年份:2015
-
负责人:CANDYCE H KROENKE
-
依托单位:
Social networks, breast cancer treatment, and survival
-
批准号:9756142
-
项目类别:
-
资助金额:$16.62万
-
财政年份:2015
-
负责人:CANDYCE H KROENKE
-
依托单位:
Social Networks & Breast Cancer Prognosis in the Chinese and US Evaluation Study
-
批准号:8547798
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项目类别:
-
资助金额:$7.15万
-
财政年份:2012
-
负责人:CANDYCE H KROENKE
-
依托单位:
Social Networks & Breast Cancer Prognosis in the Chinese and US Evaluation Study
-
批准号:8402032
-
项目类别:
-
资助金额:$7.67万
-
财政年份:2012
-
负责人:CANDYCE H KROENKE
-
依托单位:
海外基金