Table 2.
Performance of screening questions and ICD-10 Z codes for social risk factor screening measurement compared to validated survey instruments
| Social factor | n | Sensitivity | Specificity | Positive predictive value (PPV) | Area under the curve (AUC) |
|---|---|---|---|---|---|
| Financial strain | |||||
| screening questionsa | 57 | 28.0 (12.1, 49.4) | 93.8 (79.2, 99.2) | 77.8 (40.0, 47.4) | 0.609 (0.509, 0.708) |
| ICD-10 Z codesb | 170 | 10.3 (4.5, 19.2) | 96.7 (90.8, 99.3) | 72.7 (39.0, 94.0) | 0.535 (0.496, 0.573) |
| Transportation | |||||
| screening questions | 57 | 50.0 (23.0, 77.0) | 90.7 (77.9, 97.4) | 63.6 (30.8, 89.1) | 0.703 (0.561, 0.846)* |
| ICD-10 Z codes | 174 | 11.6 (5.1, 21.6) | 94.3 (88.0, 97.9) | 57.1 (28.9, 82.3) | 0.529 (0.485, 0.574) |
| Food insecurity | |||||
| screening questions | 52 | 66.7 (38.4, 88.2) | 73.0 (55.9, 86.2) | 50.0 (27.2, 72.8) | 0.698 (0.555, 0.841)* |
| ICD-10 Z codes | 164 | 4.7 (1.0, 13.1) | 100.0 (96.4, 100.0) | 100.0 (29.2, 100.0) | 0.523 (0.487, 0.550) |
| Housing instability | |||||
| screening questions | 44 | 50.0 (24.7, 75.3) | 92.9 (76.5, 99.1) | 80.0 (44.4, 97.5) | 0.714 (0.579, 0.850)* |
| ICD-10 Z codes | 165 | 10.0 (4.1, 19.5) | 96.8 (91.0, 99.3) | 70.0 (34.8, 93.3) | 0.534 (0.495, 0.574) |
*p < 0.05 comparison of AUC values
aScreening questions extracted from the EHR
bICD-10 Z codes see Appendix