Addressing Social Determinants of Health in Systemic Lupus Erythematosus

Lupus, a chronic autoimmune disease affecting multiple organ systems, encompasses a diverse range of clinical manifestations. Systemic lupus erythematosus (SLE), the most prevalent form of lupus, presents with considerable heterogeneity, posing substantial challenges in disease management for patients, providers, and caregivers. Despite overall improvements in SLE outcomes, disparities persist across racial and ethnic minorities and socially disadvantaged populations. For instance, Black and Hispanic individuals exhibit higher SLE disease activity, poorer pregnancy and cardiovascular outcomes, reduced quality of life, and elevated mortality rates. These disparities often stem from inadequate social determinants of health (SDoH), which also contribute to SLE deterioration and suboptimal outcomes. Recognizing the critical role of addressing these unmet social needs in SLE management, we integrate real- world data (RWD), artificial intelligence (AI), and natural language processing (NLP) to tackle data and methods challenges and propose to develop a social risk management tool that aims to transform SLE clinical care by integrating social care, facilitating a much-needed paradigm shift in US health care delivery. This SBIR project is an interdisciplinary collaboration among Polygon Health Analytics LLC and the University of Florida. By leveraging RWD from the OneFlorida+ network and an exposome database capturing contextual SDoH, we aim to (1) establish an individualized polysocial risk score (iPsRS), which assesses increased social risk essential to SLE flares, and (2) employ causal AI models to estimate the causal effect of SDoH on SLE flares to identify the effective targets for social interventions. (Aim 1) Moreover, collaborating with diverse stakeholders, our team will prototype a digital health tool named iSMILE (Individualized Social Risk Management In Systematic Lupus Erythematosus CarE) through a user-centered design (UCD) approach and develop thoughtful qualitative studies to develop next-step implementation recommendations and commercialization plans. (Aim 2) This project is highly feasible and potentially transformative for creating novel social care for SLE patients. It will deliver a prototype of a social risk management tool tailored for individual SLE patients with input from various stakeholders along with a set of prioritized strategies for implementation. We will also refine a step-by-step commercialization plan to identify a viable business model, targeting various stakeholders (e.g., patients, payers, and pharma companies), in order to further develop the ISMILE into a real commercial tool with a bigger scope through a SBIR Phase II project.