Evaluating bias in electronic health record data: using agent-based models to examine whether geographic disparities in community-acquired Methicillin-resistant Staphylococcus aureus are due to differential healthcare-seeking behaviors.

Electronic health records (EHR) are increasingly used in public health research. However, biases may exist when using EHR due to whether someone is captured in the data. Assessing the impact of bias in generating disparities identified with EHR data is difficult because information about healthcare-seeking behaviors is not included in the record.

Breast cancer screening needs assessment in 19 Northern California counties: geography, poverty, and racial/ethnic identity composition.

Purpose: To describe the area-level rate of breast cancers, the percentage of early-stage diagnoses (stage I-IIa), and associations between area-level measures of poverty, racial/ethnic composition, primary care shortage, and urban/rural/frontier status for the UC Davis Comprehensive Cancer Center (UCDCCC) catchment area.

Methods: Using data from the SEER Cancer Registry of Greater California (2014-2018) and the California Department of Health Care Access and Information Medical Service Study Area, we conducted an ecological study in the UCDCCC catchment area to identify geographies that need screening interventions and their demographic characteristics.

Results: The higher the percentage of the population identifying as Hispanic/Latino/Latinx, and the higher the percentage of the population below the 100% poverty level, the lower the odds of being diagnosed at an early-stage (OR = 0.

Community-acquired Staphylococcus aureus skin and soft tissue infection risk assessment using hotspot analysis and risk maps: the case of California emergency departments.

Background: Community-acquired Staphylococcus aureus (CA-Sa) skin and soft tissue infections (SSTIs) are historically associated with densely populated urban areas experiencing high poverty rates, intravenous drug use, and homelessness. However, the epidemiology of CA-Sa SSTIs in the United States has been poorly understood since the plateau of the Community-acquired Methicillin-resistant Staphylococcus aureus epidemic in 2010. This study examines the spatial variation of CA-Sa SSTIs in a large, geographically heterogeneous population and identifies neighborhood characteristics associated with increased infection risk.

A Bayesian multilevel analysis exploring population-level effects mediating the relationship between area-level poverty and community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) infection across California communities.

Poverty is an often-cited driver of health disparities, and associations between poverty and community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) infection are well documented. However, the pathways through which poverty influences infection have not been thoroughly examined. This project aims to identify mediating variables, or mechanisms, explaining why area-level poverty is associated with CA-MRSA infection in Californians.

Use of clinical decision support for antibiotic stewardship in the emergency department and outpatient clinics: An interrupted time-series analysis.

Objective: To evaluate the impact of implementing clinical decision support (CDS) tools for outpatient antibiotic prescribing in the emergency department (ED) and clinic settings.

Design: We performed a before-and-after, quasi-experimental study that employed an interrupted time-series analysis.

Setting: The study institution was a quaternary, academic referral center in Northern California.