Social and behavioral determinants of health (SBDH) are environmental and behavioral factors that impede disease self-management and can exacerbate clinical conditions. While recent research in the informatics community has focused on building systems that can automatically infer SBDH from the patient record, it is unclear how such determinants change overtime. This study analyzes the longitudinal characteristics of 4 common SBDH as expressed in the patient record and compares the rates of change among distinct SBDH. In addition, manual review of patient notes was undertaken to establish whether changes in patient SBDH status reflected legitimate changes in patient status or rather data quality issues. Our findings suggest that a patient’s SBDH status is liable to change over time and that some changes reflect poor social history taking by clinicians.

Learning Objective: Understand the characteristics of how social and behavioral determinants are expressed in longitudinal patient records, and be able to discuss potential data quality issues that may challenge the use of automated techniques to extract this information.


Daniel Feller (Presenter)
Columbia University

Jason Zucker, Columbia University
Oliver Bear Don't Walk, Columbia University
Michael Yin, Columbia University
Peter Gordon, Columbia University
Noemie Elhadad, Columbia University

Presentation Materials: