Systematic Design and Data-Driven Evaluation of Social Determinants of Health Ontology (SDoHO)

Authors

Yifang Dang
Fang Li
Xinyue Hu
Vipina K Keloth
Meng Zhang
Sunyang Fu
Muhammad F Amith
J Wilfred Fan
Jingcheng Du
Evan Yu
Hongfang Liu
Xiaoqian Jiang
Hua Xu
Cui Tao

Publication Date

8-18-2023

Journal

Journal of the American Medical Informatics Association

Abstract

Objective: Social determinants of health (SDoH) play critical roles in health outcomes and well-being. Understanding the interplay of SDoH and health outcomes is critical to reducing healthcare inequalities and transforming a "sick care" system into a "health-promoting" system. To address the SDOH terminology gap and better embed relevant elements in advanced biomedical informatics, we propose an SDoH ontology (SDoHO), which represents fundamental SDoH factors and their relationships in a standardized and measurable way.

Material and methods: Drawing on the content of existing ontologies relevant to certain aspects of SDoH, we used a top-down approach to formally model classes, relationships, and constraints based on multiple SDoH-related resources. Expert review and coverage evaluation, using a bottom-up approach employing clinical notes data and a national survey, were performed.

Results: We constructed the SDoHO with 708 classes, 106 object properties, and 20 data properties, with 1,561 logical axioms and 976 declaration axioms in the current version. Three experts achieved 0.967 agreement in the semantic evaluation of the ontology. A comparison between the coverage of the ontology and SDOH concepts in 2 sets of clinical notes and a national survey instrument also showed satisfactory results.

Discussion: SDoHO could potentially play an essential role in providing a foundation for a comprehensive understanding of the associations between SDoH and health outcomes and paving the way for health equity across populations.

Conclusion: SDoHO has well-designed hierarchies, practical objective properties, and versatile functionalities, and the comprehensive semantic and coverage evaluation achieved promising performance compared to the existing ontologies relevant to SDoH.

Keywords

Humans, Social Determinants of Health, Semantics, Health Equity, Healthcare Disparities

DOI

10.1093/jamia/ocad096

PMID

37301740

PMCID

PMC10436148

PubMedCentral® Posted Date

6-10-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes