Social Determinants of Health in Physiatry: Challenges and Opportunities for Clinical Decision Making and Improving Treatment Precision

Abstract

Physiatry is a medical specialty focused on improving functional outcomes in patients with a variety of medical conditions that affect the brain, spinal cord, peripheral nerves, muscles, bones, joints, ligaments, and tendons. Social determinants of health (SDH) play a key role in determining therapeutic process and patient functional outcomes. Big data and precision medicine have been used in other fields and to some extent in physiatry to predict patient outcomes, however many challenges remain. The interplay between SDH and physiatry outcomes is highly variable depending on different phases of care, and more favorable patient profiles in acute care may be less favorable in the outpatient setting. Furthermore, SDH influence which treatments or interventional procedures are accessible to the patient and thus determine outcomes. This opinion paper describes utility of existing datasets in combination with novel data such as movement, gait patterning and patient perceived outcomes could be analyzed with artificial intelligence methods to determine the best treatment plan for individual patients in order to achieve maximal functional capacity.

Digital Transformation in Measuring Social Determinants of Health

“…• Structured data (Blosnich et al, 2020;Caryn et al, 2014;Downs et al, 2019;Feller et al, 2019;Kepper et al, 2023;Lasser et al, 2023;Rogers et al, 2022;Sills et al, 2016) • Unstructured data (Bejan et al, 2018;Bhavsar et al, 2020;Bucher et al, 2019;Conic et al, 2021;Feller et al, 2018;Goodday et al, 2020;Gundlapalli et al, 2013;Gundlapalli et., 2014;Hatef et al, 2021;Hatef et al, 2022;Hazlehurst et al, 2014;Lybarger et al, 2021;Navathe et al, 2018;Reeves et al, 2021;Shoenbill et al, 2020;Stemerman et al, 2021;Topaz et al, 2019;Winden et al, 2018;Yu et al, 2022;Zhu et al, 2019) Mobile devices data (n = 4)…”