# Developing A Fair Individualized Polysocial Risk Score (iPsRS) for Identifying Increased Social Risk of Hospitalizations in Patients with Type 2 Diabetes (T2D)

arXiv: https://arxiv.org/abs/2309.02467 · HTML: https://mlsanity.com/paper/2309.02467/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 81 references that are in the map.
- First posted on arXiv 5 Sep 2023.

## Builds on (most cited first, 10 of 10)

- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [Certifying and removing disparate impact](https://mlsanity.com/paper/1412.3756/) (2014)
- [Fair prediction with disparate impact: A study of bias in recidivism prediction instruments](https://mlsanity.com/paper/1610.07524/) (2016)
- [Mitigating Unwanted Biases with Adversarial Learning](https://mlsanity.com/paper/1801.07593/) (2018)
- [On Fairness and Calibration](https://mlsanity.com/paper/1709.02012/) (2017)
- [Imbalanced-learn: A Python Toolbox to Tackle the Curse of Imbalanced Datasets in Machine Learning](https://mlsanity.com/paper/1609.06570/) (2016)
- [A Clarification of the Nuances in the Fairness Metrics Landscape](https://mlsanity.com/paper/2106.00467/) (2021)
- [Doubly robust treatment effect estimation with missing attributes](https://mlsanity.com/paper/1910.10624/) (2019)
- [A Study of Social and Behavioral Determinants of Health in Lung Cancer Patients Using Transformers-based Natural Language Processing Models](https://mlsanity.com/paper/2108.04949/) (2021)
- [SODA: A Natural Language Processing Package to Extract Social Determinants of Health for Cancer Studies](https://mlsanity.com/paper/2212.03000/) (2022)

## Abstract (arXiv)

Background: Racial and ethnic minority groups and individuals facing social disadvantages, which often stem from their social determinants of health (SDoH), bear a disproportionate burden of type 2 diabetes (T2D) and its complications. It is therefore crucial to implement effective social risk management strategies at the point of care. Objective: To develop an EHR-based machine learning (ML) analytical pipeline to identify the unmet social needs associated with hospitalization risk in patients with T2D. Methods: We identified 10,192 T2D patients from the EHR data (from 2012 to 2022) from the University of Florida Health Integrated Data Repository, including contextual SDoH (e.g., neighborhood deprivation) and individual-level SDoH (e.g., housing stability). We developed an electronic health records (EHR)-based machine learning (ML) analytic pipeline, namely individualized polysocial risk score (iPsRS), to identify high social risk associated with hospitalizations in T2D patients, along with explainable AI (XAI) techniques and fairness assessment and optimization. Results: Our iPsRS achieved a C statistic of 0.72 in predicting 1-year hospitalization after fairness optimization across racial-ethnic groups. The iPsRS showed excellent utility for capturing individuals at high hospitalization risk; the actual 1-year hospitalization rate in the top 5% of iPsRS was ~13 times as high as the bottom decile. Conclusion: Our ML pipeline iPsRS can fairly and accurately screen for patients who have increased social risk leading to hospitalization in T2D patients.