Objective
We sought to assess the quality of race and ethnicity information in observational health databases, including electronic health records (EHRs), and to propose patient self-recording as an improvement strategy.
Materials and Methods
We assessed completeness of race and ethnicity information in large observational health databases in the United States (Healthcare Cost and Utilization Project and Optum Labs), and at a single healthcare system in New York City serving a racially and ethnically diverse population. We compared race and ethnicity data collected via administrative processes with data recorded directly by respondents via paper surveys (National Health and Nutrition Examination Survey and Hospital Consumer Assessment of Healthcare Providers and Systems). Respondent-recorded data were considered the gold standard for the collection of race and ethnicity information.
Results
Among the 160 million patients from the Healthcare Cost and Utilization Project and Optum Labs datasets, race or ethnicity was unknown for 25%. Among the 2.4 million patients in the single New York City healthcare system’s EHR, race or ethnicity was unknown for 57%. However, when patients directly recorded their race and ethnicity, 86% provided clinically meaningful information, and 66% of patients reported information that was discrepant with the EHR.
Discussion
Race and ethnicity data are critical to support precision medicine initiatives and to determine healthcare disparities; however, the quality of this information in observational databases is concerning. Patient self-recording through the use of patient-facing tools can substantially increase the quality of the information while engaging patients in their health.
Conclusions
Patient self-recording may improve the completeness of race and ethnicity information.
The Australian sugar industry produces 4 million tonnes of sugar products from 30 million tonnes of sugarcane annually producing a large amount of wastes. Sugarcane mill mud, one of the wastes from sugar mills, was hydrothermally activated at 250 C for 4 hours to produce an economically feasible adsorbent to demonstrate as a pesticide adsorbent. The hydrothermally activated mill mud displayed distinct chemical and physical changes as well as modified surface characteristics, as determined by electron microscopy characterisation and X-ray photoelectron spectroscopy. The hydrothermal activation process changed the physical composition from agglomerated multi-layered structures to distinctive structures possessing mono-layered features. The maximum adsorption capacities for organic molecules, as characterised by using the methylene blue dye assay, showed at least a 3-fold increase after activation. The adsorption process for the hydrothermally activated displays a mono-layer adsorption profile whilst the untreated mill mud sample affords multi-layer adsorption, observations that are consistent with their respective physical structures. Of interest, the absorptivity of the activated material was tested against Imidacloprid, a common pesticide used widely in sugarcane farms, to assess its viability as a pesticide adsorbent. The adsorption capacity was comparable to the reference activated carbon and much higher than commercially available coconut derived activated carbon, demonstrating its potential application as a runoff barrier for sugarcane farms.
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