Willy Gräfe, Lukas Liebig, Tobias Deutsch, Jeannine Schübel, Antje Bergmann, Markus Bleckwenn, Thomas Frese, Christine Brütting, Henna Riemenschneider
Saxon Epidemiological Study in General Practice-6 (SESAM-6): protocol of a cross-sectional study
BMJ open
background prior research suggests association clinical outcomes heart failure hf social determinants health sdoh providers identify address sdoh care delivery evaluated sdoh defined measured evaluated studies examine hf outcomes methods results following preferred reporting items systematic reviews metaanalysis guidelines databases searched observational interventional studies published 2009 2021 assessed influence sdoh outcomes selected articles assessed quality using validated rating scheme identified 1373 unique articles screening 104 selected fulltext review 59 met inclusion criteria including retrospective prospective cohort crosssectional intervention studies majority examined readmissions hospitalizations k33 mortality survival k29 success medical devices transplantation k8 sdoh examined commonly included race ethnicity age sex socioeconomic status education health literacy studies used range 1 9 sdoh primary independent variables 0 7 sdoh controls multiple data sources employed frequently electronic medical records linked national surveys disease registries effects sdoh hf outcomes inconsistent heterogeneity data sources sdoh constructs conclusions systematic review reveals shortcomings measurement deployment sdoh variables hf care validated measures need prospectively intentionally collected facilitate appropriate analysis reporting replication data across studies inform design appropriate evidencebased interventions ameliorate significant hf morbidity societal costs