Add wos sample results library

02-data/intermediate/wos_sample/424109407b3c86ed8871e551673c5f9e-bernstein-david-n./info.yaml

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+abstract: 'BackgroundIt is well documented that routinely collected patient
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+  sociodemographic characteristics (such as race and insurance type) and
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+  geography-based social determinants of health (SDoH) measures (for
+
+  example, the Area Deprivation Index) are associated with health
+
+  disparities, including symptom severity at presentation. However, the
+
+  association of patient-level SDoH factors (such as housing status) on
+
+  musculoskeletal health disparities is not as well documented. Such
+
+  insight might help with the development of more-targeted interventions
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+  to help address health disparities in orthopaedic
+
+  surgery.Questions/purposes(1) What percentage of patients presenting for
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+  new patient visits in an orthopaedic surgery clinic who were unemployed
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+  but seeking work reported transportation issues that could limit their
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+  ability to attend a medical appointment or acquire medications, reported
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+  trouble paying for medications, and/or had no current housing? (2)
+
+  Accounting for traditional sociodemographic factors and patient-level
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+  SDoH measures, what factors are associated with poorer patient-reported
+
+  outcome physical health scores at presentation? (3) Accounting for
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+  traditional sociodemographic factor patient-level SDoH measures, what
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+  factors are associated with poorer patient-reported outcome mental
+
+  health scores at presentation?MethodsNew patient encounters at one Level
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+  1 trauma center clinic visit from March 2018 to December 2020 were
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+  identified. Included patients had to meet two criteria: they had
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+  completed the Patient-Reported Outcome Measure Information System
+
+  (PROMIS) Global-10 at their new orthopaedic surgery clinic encounter as
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+  part of routine clinical care, and they had visited their primary care
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+  physician and completed a series of specific SDoH questions. The SDoH
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+  questionnaire was developed in our institution to improve data that
+
+  drive interventions to address health disparities as part of our
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+  accountable care organization work. Over the study period, the SDoH
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+  questionnaire was only distributed at primary care provider visits. The
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+  SDoH questions focused on transportation, housing, employment, and
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+  ability to pay for medications. Because we do not have a way to
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+  determine how many patients had both primary care provider office visits
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+  and new orthopaedic surgery clinic visits over the study period, we were
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+  unable to determine how many patients could have been included; however,
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+  9057 patients were evaluated in this cross-sectional study. The mean age
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+  was 61 +/- 15 years, and most patients self-reported being of White race
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+  (83\% {[}7561 of 9057]). Approximately half the patient sample had
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+  commercial insurance (46\% {[}4167 of 9057]). To get a better sense of
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+  how this study cohort compared with the overall patient population seen
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+  at the participating center during the time in question, we reviewed all
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+  new patient clinic encounters (n = 135,223). The demographic information
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+  between the full patient sample and our study subgroup appeared similar.
+
+  Using our study cohort, two multivariable linear regression models were
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+  created to determine which traditional metrics (for example,
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+  self-reported race or insurance type) and patient-specific SDoH factors
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+  (for example, lack of reliable transportation) were associated with
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+  worse physical and mental health symptoms (that is, lower PROMIS scores)
+
+  at new patient encounters. The variance inflation factor was used to
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+  assess for multicollinearity. For all analyses, p values < 0.05
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+  designated statistical significance. The concept of minimum clinically
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+  important difference (MCID) was used to assess clinical importance.
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+  Regression coefficients represent the projected change in PROMIS
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+  physical or mental health symptom scores (that is, the dependent
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+  variable in our regression analyses) accounting for the other included
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+  variables. Thus, a regression coefficient for a given variable at or
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+  above a known MCID value suggests a clinical difference between those
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+  patients with and without the presence of that given characteristic. In
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+  this manuscript, regression coefficients at or above 4.2 (or at and
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+  below -4.2) for PROMIS Global Physical Health and at or above 5.1 (or at
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+  and below -5.1) for PROMIS Global Mental Health were considered
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+  clinically relevant.ResultsAmong the included patients, 8\% (685 of
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+  9057) were unemployed but seeking work, 4\% (399 of 9057) reported
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+  transportation issues that could limit their ability to attend a medical
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+  appointment or acquire medications, 4\% (328 of 9057) reported trouble
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+  paying for medications, and 2\% (181 of 9057) had no current housing.
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+  Lack of reliable transportation to attend doctor visits or pick up
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+  medications (beta = -4.52 {[}95\% CI -5.45 to -3.59]; p < 0.001),
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+  trouble paying for medications (beta = -4.55 {[}95\% CI -5.55 to -3.54];
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+  p < 0.001), Medicaid insurance (beta = -5.81 {[}95\% CI -6.41 to -5.20];
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+  p < 0.001), and workers compensation insurance (beta = -5.99 {[}95\% CI
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+  -7.65 to -4.34]; p < 0.001) were associated with clinically worse
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+  function at presentation. Trouble paying for medications (beta = -6.01
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+  {[}95\% CI -7.10 to -4.92]; p < 0.001), Medicaid insurance (beta = -5.35
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+  {[}95\% CI -6.00 to -4.69]; p < 0.001), and workers compensation (beta =
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+  -6.07 {[}95\% CI -7.86 to -4.28]; p < 0.001) were associated with
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+  clinically worse mental health at presentation.ConclusionAlthough
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+  transportation issues and financial hardship were found to be associated
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+  with worse presenting physical function and mental health, Medicaid and
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+  workers compensation insurance remained associated with worse presenting
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+  physical function and mental health as well even after controlling for
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+  these more detailed, patient-level SDoH factors. Because of that,
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+  interventions to decrease health disparities should focus on not only
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+  sociodemographic variables (for example, insurance type) but also
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+  tangible patient-specific SDoH characteristics. For example, this may
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+  include giving patients taxi vouchers or ride-sharing credits to attend
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+  clinic visits for patients demonstrating such a need, initiating
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+  financial assistance programs for necessary medications, and/or
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+  identifying and connecting certain patient groups with social support
+
+  services early on in the care cycle.'
+affiliation: 'Tobert, DG (Corresponding Author), Massachusetts Gen Hosp, Dept Orthopaed
+  Surg, 55 Fruit St, Boston, MA 02114 USA.
+
+  Bernstein, David N.; Lans, Amanda; Karhade, Aditya V.; Heng, Marilyn; Schwab, Joseph
+  H.; Tobert, Daniel G., Harvard Med Sch, Massachusetts Gen Hosp, Dept Orthopaed Surg,
+  Boston, MA USA.
+
+  Bernstein, David N.; Karhade, Aditya V., Harvard Combined Orthopaed Residency Program,
+  Boston, MA USA.
+
+  Lans, Amanda, Univ Utrecht, Univ Med Ctr Utrecht, Dept Orthopaed Surg, Utrecht,
+  Netherlands.
+
+  Bernstein, David N.; Poolman, Rudolf W., Leiden Univ, Leiden Univ Med Ctr, Dept
+  Orthopaed Surg, Leiden, Netherlands.
+
+  Tobert, Daniel G., Massachusetts Gen Hosp, Dept Orthopaed Surg, 55 Fruit St, Boston,
+  MA 02114 USA.'
+author: Bernstein, David N. and Lans, Amanda and Karhade, Aditya V. and Heng, Marilyn
+  and Poolman, Rudolf W. and Schwab, Joseph H. and Tobert, Daniel G.
+author-email: 'bernsteindavidn@gmail.com
+
+  alans@mgh.harvard.edu
+
+  akarhade@partners.org
+
+  mheng@mgh.harvard.edu
+
+  namloop@gmail.com
+
+  jhschwab@mgh.harvard.edu
+
+  dtobert@mgh.harvard.edu'
+author_list:
+- family: Bernstein
+  given: David N.
+- family: Lans
+  given: Amanda
+- family: Karhade
+  given: Aditya V.
+- family: Heng
+  given: Marilyn
+- family: Poolman
+  given: Rudolf W.
+- family: Schwab
+  given: Joseph H.
+- family: Tobert
+  given: Daniel G.
+da: '2023-09-28'
+doi: 10.1097/CORR.0000000000002446
+eissn: 1528-1132
+files: []
+issn: 0009-921X
+journal: CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
+keywords-plus: 'SYMPTOM SEVERITY; LUMBAR DISC; CARE; DISADVANTAGE; DISPARITIES;
+
+  ETHNICITY; SURGERY; METRICS; RACE'
+language: English
+month: MAY
+number: '5'
+number-of-cited-references: '39'
+orcid-numbers: 'Poolman, Rudolf/0000-0003-3178-2247
+
+  Bernstein, David/0000-0002-1784-3288'
+pages: 912-921
+papis_id: f7275c460c4223280230a1352722331a
+ref: Bernstein2023aredetailed
+researcherid-numbers: 'Bernstein, David N./AAL-2777-2021
+
+  Poolman, Rudolf/AAM-7815-2020
+
+  '
+times-cited: '2'
+title: Are Detailed, Patient-level Social Determinant of Health Factors Associated
+  With Physical Function and Mental Health at Presentation Among New Patients With
+  Orthopaedic Conditions?
+type: Article
+unique-id: WOS:000975638800017
+usage-count-last-180-days: '0'
+usage-count-since-2013: '0'
+volume: '481'
+web-of-science-categories: Orthopedics; Surgery
+year: '2023'