An informetric analysis to understand how systems science methods have been applied in health disparities research !

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Crystal Wiley Cené, MD, MPH; Laura Sheble, MLIS; Gaurav Dave, MD, DrPH; �Kristen Hassmiller Lich, PhD; Tiarney D. Ritchwood, PhD; Giselle Corbie-Smith, MD, MSc

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We used a combination of pearl growing and iterative scanning to identify IBM, SD, and NA publications. We searched PubMed with methods queries ‘AND’ed with the ‘disparities’ search adapted from Anderson and colleagues (2012); downloaded PubMed xml files; and parsed records with custom R scripts to extract key variables including publication year, MeSH terms, and journal name, both within and across result sets. Additionally, Web of Knowledge (WOK)-enhanced MEDLINE records were collected based on PubMed IDs identified with our initial search. WOK records were parsed with custom R scripts and BiblioTools 2.0 (Grauwin & Jensen, 2009) to extract author and WOK subject category data, which were visualized with Gephi (Bastian, Heymann & Jacomy, 2009) and VOSviewer (van Eck & Waltman, 2010), respectively.  

Search Queries:  Individual-based modeling: Q1 NOT (Q1 AND Animals[Mesh:noexp]) Q1: [Title/Abstract/OT:] ("agent based" AND “model(s/er/ler/ing/ling)”) OR "agent based simulation(s)” OR microsimulation(s) OR "+individual based model(s/er/ler/ing/ling)” OR "+individual based simulation(s)” OR "+individual based computer simulation" OR "+individual based mathematical model" OR ("discrete event" AND simulation) OR "discrete event simulation”

System Dynamics: Q2 NOT (Q2 AND Animals[Mesh:noexp]) Q2: [Title/Abstract/OT:] "system dynamics" OR [All Fields:] ("causal loop(s)” AND "system(s)”)) OR "causal loop diagram(s)”

Network analysis: Q3 NOT (Q3 AND Animals[Mesh:noexp]) AND Q4 (Disparities search) Q3: [All Fields:] "network effects" OR sociometric OR "sociometry" OR "network analys(ei)s" OR "network intervention(s)" OR "network model(s/ing/ling)" OR [Journal:] "Social Networks" OR [Mesh Terms:] "sociometric techniques”

Disparities (Adapted from Anderson et al., 2012): Q4: Q4.1 OR Q4.2 OR Q4.3 OR Q4.4 OR Q4.5 Q4.1: [MeSH Terms:] ("medically underserved area” OR "poverty areas" OR "vulnerable populations" OR "minority groups" OR "health status disparities" OR "ethnic groups+" OR "continental population groups+" OR "population groups" OR "socioeconomic factors+" OR "social environment") AND [Title/Abstract:] ("disparit(y/ies)" OR "inequit(y/ies" OR “inequality(y/ies)" OR "equalit(y/ies)" OR "equit(y/ies)" OR "disadvantage(s)")

Q4.2: [Title/Abstract:] ("health" OR "social" OR "disease(s)" OR "morbidity" OR "mortality” OR "racial" OR "ethnic") AND ("disparit(y/ies)" OR "inequit(y/ies)" OR "inequalit(y/ies)" OR "equalit(y/ies)" OR "equit(y/ies)" OR "disadvantage(s)" OR "gradient(s)”)

Q4.3: [Title/Abstract:] ("population(s)" OR "group(s)" OR "communit(y/ies)"OR "neighbor(u)rhood(s)") AND ("disadvantages” OR “disadvantaged" OR "low income" OR "marginalized" OR "under( )served" OR "deprived" OR "deprivation" OR "poverty" OR "impoverished" OR "minority" OR "racial" OR "ethnic”)

Q4.4: [Title/Abstract:] ("low pa(y/id)" OR "unemployed" OR "unemployment" OR "deprivation" OR "deprived" OR "financial hardship" OR "benefit recipient(s)" OR "social position(s)" OR "social class(es)" OR "socioeconomic" OR "social status" OR "poverty" OR "impoverished" OR "wom(a/e)n" OR "gender") AND ("disparit(y/ies)" OR "inequit(y/ies)" OR "inequalit(y/ies)" OR "equalit(y/ies)" OR "equit(y/ies)" OR "disadvantage(s)" OR "gradient(s)")

Q4.5: [Title/Abstract:] "pacific islander(s)" OR "African American(s)" OR "Hispanic(s)" OR "latin(o/a)" OR "Asian American" OR "Alaska(n) native(s)" OR "American Indian(s)”  

References:  1. Anderson LM, Adeney KL, Shinn C, Krause LK, Safranek S. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations (Protocol). Cochrane Database Syst Rev 2012; CD009905 DOI: 10.1002/14651858.CD009905 2. Bastian M, Heymann S, Jacomy M. Gephi: an open source software for exploring and manipulating networks. Intl AAAI Conf on Weblogs & Social Media 2009. 3. Grauwin S, Jensen P. Mapping Scientific Institutions. Scientometrics 2011; 89: 943-954. 4. van Eck NJ, Waltman L. Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics 2010; 84: 523–538.

Methods  

Sample application of each method to illustrate their use in disparities research Individual-Based Modeling System Dynamics Network Analysis

REFERENCE: Lansdorp-Vogelaar I et al. Cancer Epidemiol Biomarkers Prev 2012; 21:728-736

OBJECTIVE: A microsimulation model was used to estimate colorectal cancer (CRC) mortality rates in black males and females over age 50 in the US between 1975 and 2007, assuming screening and/or stage-specific CRC survival rates equivalent to whites. They conclude that disparities in screening and stage-specific survival rates explain 19% and 36% of racial disparities in CRC mortality, respectively (approximately 50% of CRC mortality disparity when combined).

REFERENCE: Rees C et al. J Youth Adolescence 2014;43:405-425

OBJECTIVE: Race/ethnicity and adolescents’ social network structure are both important factors in the etiology of delinquent behavior. Yet, much of the minority group delinquency literature overlooks the Native American youth population that traditionally exhibits high rates of alcohol use and abuse. This analysis provides a comprehensive description of the structural characteristics of Native American youths’ friendship networks and compares and contrasts these to other racial/ethnic groups.

REFERENCE: BeLue R et al. Health Educ Behav 2012;39:745-751

OBJECTIVE: In 2006, the Pennsylvania Department of Health launched a State Health Improvement Plan (SHIP). One of it’s affiliate partners – the Clinton County Healthy Communities Community Health Outreach Coalition conducted a Causal Loop Diagramming exercise at one of their meetings to understand and address adolescent drinking in rural Pennsylvania.

Most common journals publishing systems science and disparities manuscripts, by method

Publication trends, by method

Journal Number Journal Number Journal NumberProceedings  of  the  National  Academy  of  Sciences  of  the  United  States  of  America

4 Community  Mental  Health  Journal 1 PLoS  One 8

Social  Security  Bulletin 4 Drug  and  Alcohol  Review 1 Child  Development 7BMJ  Open 2 Environmental  Health  Perspectives 1 Social  Science  &  Medicine 5Health  Affairs 2 Global  Health  Promotion 1 BMC  Public  Health 4Journal  of  Theoretical  Biology 2 Health  Education  &  Behavior 1 Journal  of  Abnormal  Child  Psychology 4Physical  review.  E,  Statistical,  nonlinear,  and  soft  matter  physics

2 Journal  of  manipulative  and  physiological  therapeutics

1 Journal  of  Youth  and  Adolescence 4

Pharmacoeconomics 2 Medical  Hypotheses 1 AIDS  Education  and  Prevention 3Social  Science  &  Medicine 2 Simulation  in  Healthcare 1 American  Journal  of  Public  Health 3PLoS  One 1 Social  Science  &  Medicine 1 Annals  of  Human  Genetics 3Medical  Decision  Making 1 Theoretical  biology  &  medical  

modelling1 International  Journal  of  Health  

Geographics3

Individual-­‐Based  Modeling System  Dynamics Network  Analysis

Note: Individual-Based Modeling, System Dynamics, and Network Analysis papers published across 50, 10, and 120 distinct journals, respectively.

Web of Science Density Map

Morris M

Xie Y

Callander EJKelly SJ

Graham S

Derenko M

Osgood NDMahamoud A

Macintyre S

Passey MEPercival RScho!eld DJShrestha RN

Peipins LAYoung RFlanagan B

Grzybowski TDambueva I

Denisova G

Zakharov I

Malyarchuk B

Wozniak M

Hui PM

Smith PMIllig SB

Ottenbacher KJ

Granger CV

Clarke GPRigby JE

Lansdorp-Vogelaar I

Palmer PH

Dignan MB

Marmot MG

van Ballegooijen M

Jemal A

Zauber AG

Eng E

Pettit GSDodge KA

Tanjasiri SPValente TW

Latkin C

Amiri M

Bates JECoie JD

Lewis B

Linn RT

The collaboration network is sparse (density = 0.008). Of 183 total components, 164 described single paper events. In components that describe more than one publication, 4 instances of repeat collaborations, primarily between the same authors, are visible (e.g., Shrestha et al., Lansdorp-Vogelaar et al.). A few authors developed new collaborative relationships from paper to paper (e.g., Latkin, Valente, Dodge).Authors per paper ranged from 1 to 36, with a median of 4 (IQR:2,6). Authors contributed to 1 to 4 papers each.

Components with 2+ papers and 3 authors OR 4+ authors are visualized with the Fruchterman Reingold algorithm. [Nodes size = Number of papers; node color = betweenness centrality, red (high) to blue (low); edge width, color = Number of collaborations. Not shown: 17 isolates, 31 dyads, 31 complete triads]

MeSH: Whom and What

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We categorized MeSH descriptors as ‘socio-cultural/demographic’ (‘scd’), ‘topic’, ‘methods’ or ‘other’ to understand whom and what is studied using systems science methods. Scd-related descriptors that occurred more than 4 times (left), and ‘topic’ more than 5 (right) are charted. Scd was given priority: scd-related topics included at left.

Unique descriptors in set: 871 Assigned >1 time: 375 Most assigned: ‘Humans’ (174)

Co-authorship network

Health disparities are pervasive, persistent, and driven by dynamic factors at multiple levels. Yet, most methods for explicating health disparities rely on reductionist approaches. Systems science methodologies (e.g., Individual-Based Modelling (IBM), System Dynamics (SD), Network Analysis (NA)) can explicitly capture the complexity and interdependencies characterizing disparities. While applications of these methods abound, little is known about how these methods have been used in health disparities research. The objective of this study is to use informetric analysis to assess how disparities research using IBM, SD and NA has evolved; understand research trends; and identify critical gaps that can be addressed.  

Background and Purpose  We identified 232 distinct publications including IBM, SD, and NA applied to disparities-relevant research dating from 1970, with fewer (43%) published before 2010. NA (164 publications) and IBM (59 publications) are used more frequently than SD (10 publications).  

Results overview Conclusions •  Publications were found for each method, though

fewer than expected present actual applications •  Currently, very limited application of System

Dynamics to disparities research

•  Need to extend search outside of PubMed •  Though several champions of these systems

science methods are active in disparities research, serving as bridges between research groups, more are needed