TOPIC 423 (PHASE II): AN INTEGRATED MULTI-LEVEL DECISION SUPPORT PLATFORM TO ADDRESS PATIENT-CENTERED AND EVIDENCE-BASED SOCIAL DETERMINANTS OF HEALTH AMONG CANCER PATIENTS.

大量证据表明，在卫生保健系统内解决健康的社会决定因素（SDH）可以提高癌症治疗的依从性，并减少结果的差异；然而，很少有研究真正干预并提供资源来满足癌症患者的SDH。将SDH与内置在电子健康记录（EHR）中的临床决策支持（CDS）系统中的临床信息集成是解决癌症差异的重要方法。我们建议：(1)提供一个功能齐全的产品，包括面向患者和面向提供者的接口，以满足SDH需求；(2)在随机对照试验中对其进行测试，以评估其对癌症患者临床终点和用户满意度的影响；(3)将其集成到学术和社区医院的生产环境中，以评估其在现实世界中的使用情况。我们的方法结合了来自软件工程、肿瘤学和社会流行病学的专业知识。我们的解决方案将通过收集患者的相关SDH信息并推荐基于证据的临床行动来满足患者的SDH需求，从而提高肿瘤治疗效果，从而增强肿瘤实践。我们的解决方案将患者与实际资源连接起来，以满足他们的SDH需求，并简化与患者及其护理团队的决策支持沟通，从而可能减少患者和社会的差异和癌症负担。

A strong body of evidence suggests that addressing Social Determinants of Health (SDH) within healthcare systems advances cancer treatment adherence and reduces disparities in outcomes; however, few studies actually intervene and provide resources to meet cancer patients’ SDH. Integrating SDH with clinical information within operational Clinical Decision Support (CDS) systems built into Electronic Health Records (EHR) is an essential approach for addressing cancer disparities. We propose: (1) Providing a fully functional product with patient-facing and provider-facing interfaces to address SDH needs, (2) Testing it in a randomized controlled trial to assess its impact on cancer patient clinical endpoints and user satisfaction, and (3) Integrating it into the production environment in both academic and community-based hospitals to evaluate its use in a real-world setting. Our approach combines expertise from software engineering, oncology, and social epidemiology. Our solution will enhance oncology practice by collecting relevant SDH information from patients and recommending evidence-based clinical actions addressing patient SDH needs, resulting in improved cancer treatment outcomes. Our solution will connect patients to actual resources to meet their SDH needs and streamline communication with decision support for patients and their care teams, potentially reducing disparities and the burden of cancer on the patient and society.