Predictive Analytic Method Creates COVID-19 Health Disparities

Yale University researchers suggest that a standard measurement that uses predictive analytics to determine which COVID-19 patients have the best chances of survival could promote health disparities among diverse populations.

Throughout the COVID-19 pandemic, physicians in some areas have had to make difficult decisions regarding which patients should receive scarce health care resources.

With predictive analytics, providers can identify which patients have the best chance of survival and allocate resources and treatments to them. However, researchers indicate that these standards could negatively impact racial and ethnic minority populations.

In a previous study, researchers found that Black patients admitted to Yale New Haven Health System hospitals with COVID-19 typically had higher Sequential Organ Failure Assessment (SOFA) scores than White patients. According to the standard, the higher a patient’s SOFA score, the lower their chance of survival is.

Another study indicated that while Black patients admitted to the Yale New Haven Health System tend to have higher SOFA scores than those from other racial and ethnic groups, their mortality rates are about the same.

“If we adopt this protocol, we could end up disproportionally steering resources away from Black patients and towards other groups,” director of Yale New Haven Health’s Center for Clinical Ethics Benjamin Tolchin said in a press release.

Since the beginning of the pandemic, some health facilities have had to triage patients due to limited resources. During the first wave in spring of 2020, some hospitals in northern Italy and New York City lacked the staff and equipment, including ventilators and hemodialysis machines, necessary to assist in all emergency cases. 

“What happened was that clinicians were making resource allocations decisions on a case-by-case basis, with some preference given to younger patients who were less likely to die from severe infection,” Tolchin said.

While some hospitals began contemplating using crisis standards of protocols, including those that rely on criteria such as SOFA scores, these protocols have rarely been used. However, in Idaho, physicians have been forced to ration medical care to respond to the latest surge in COVID-19 infection, adopting SOFA scores to make decisions.

Developed in 1996, the SOFA scoring system calculates the mortality of patients with sepsis based on the function of six organ systems.

“When we looked at this earlier this year, we were thinking of devising crisis standard of care recommendations that might be adopted in future pandemics,” Tolchin said. “We didn’t think we would be needing them so quickly.”

To decrease health disparities among racial and ethnic minority populations, a better way to assess survival rates and promote health equality is needed.