Table_3_Social Determinants of Health in Physiatry: Challenges and Opportunities for Clinical Decision Making and Improving Treatment Precision.DOCX

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.

康复医学是一门专注于改善患有影响大脑、脊髓、周围神经、肌肉、骨骼、关节、韧带和肌腱等各式各样医学状况的患者功能结果的医学专科。健康的社会决定因素（SDH）在决定治疗过程和患者功能结果中扮演着关键角色。大数据和精准医学在其他领域得到了应用，并在一定程度上应用于康复医学以预测患者结果，然而仍存在许多挑战。健康的社会决定因素与康复医学结果之间的相互作用因护理的不同阶段而高度可变，而在急性护理阶段更为有利的患者特征在门诊环境中可能就不那么有利。此外，健康的社会决定因素影响着患者可获取的治疗或干预程序，从而决定了结果。本文旨在探讨利用现有数据集与新型数据，如运动、步态模式及患者感知结果相结合，通过人工智能方法分析，以确定针对个体患者的最佳治疗方案，以期实现最大化的功能能力。