Journal article
Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis
Annals of otology, rhinology & laryngology, Vol.130(10), pp.1116-1124
10/01/2021
DOI: 10.1177/0003489421995283
PMCID: PMC8762607
PMID: 33629608
Abstract
Objectives: To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients. Methods: Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of the North American Airway Collaborative (NoAAC) and via an online iSGS support community on Facebook. Patient-specific SDH factors included highest educational attainment (self-reported), median household income (matched from home zip code via U.S. Census data), and number of close friends (self-reported) as a measure of social support. Main outcomes of interest were time to disease diagnosis (years from symptom onset), treatment selection (endoscopic dilation [ED] vs cricotracheal resection [CTR] vs endoscopic resection with adjuvant medical therapy [ERMT]), and time to recurrent surgical intervention (number of days from initial surgical procedure) as a surrogate for disease recurrence. Results: The total 810 participants were 98.5% female, 97.2% Caucasian, and had a median age of 50 years (IQR, 43-58). The cohort had a median household income of $62 307 (IQR, $50 345-$79 773), a median of 7 close friends (IQR, 4-10), and 64.7% of patients completed college or graduate school. Education, income, and number of friends were not associated with time to diagnosis via multivariable linear regression modeling. Univariable multinominal logistic regression demonstrated an association between education and income for selecting ED versus ERMT, but no associations were noted for CTR. No associations were noted for time to recurrent surgical procedure via Kaplan Meier modeling and Cox proportional hazards regression. Conclusions: Patient education, income, and social support were not associated with time to diagnosis or time to disease recurrence. This suggests additional patient, procedure, or disease-specific factors contribute to the observed variations in iSGS surgical outcomes.
Details
- Title: Subtitle
- Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis
- Creators
- Jaclyn Lee - Vanderbilt UniversityLi-Ching Huang - Vanderbilt UniversityLynn D. Berry - Vanderbilt UniversityCatherine Anderson - Australian Market & Social Res Soc, Glebe, NSW, AustraliaMilan R. Amin - New York UniversityMichael S. Benninger - Cleveland ClinicJoel H. Blumin - Medical College of WisconsinJonathan M. Bock - Medical College of WisconsinPaul C. Bryson - Cleveland ClinicPaul F. Castellanos - University of Alabama at BirminghamSheau-Chiann Chen - Vanderbilt UniversityMatthew S. Clary - University of Colorado DenverSeth M. Cohen - Duke UniversityBrianna K. Crawley - Loma Linda UniversitySeth H. Dailey - Loma Linda UniversityJames J. Daniero - University of VirginiaAlessandro De. Alarcon - University of CincinnatiDonald T. Donovan - Baylor College of MedicineEric S. Edell - Mayo ClinicDale C. Ekbom - Mayo ClinicDaniel S. Fink - University of Colorado DenverRamon A. Franco - Harvard UniversityC. Gaelyn Garrett - Vanderbilt UniversityElizabeth A. Guardiani - University of Maryland, BaltimoreAlexander T. Hillel - Johns Hopkins UniversityHenry T. Hoffman - University of IowaNorman D. Hogikyan - University of MichiganRebecca J. Howell - University of CincinnatiLena K. Hussain - Vanderbilt UniversityMichael M. Johns - University of Southern CaliforniaJan L. Kasperbauer - Mayo ClinicSid M. Khosla - University of CincinnatiCheryl Kinnard - Vanderbilt UniversityRobbi A. Kupfer - University of Michigan–Ann ArborAlexander J. Langerman - Vanderbilt UniversityRobert J. Lentz - Vanderbilt UniversityRobert R. Lorenz - Medical College of WisconsinDavid G. Lott - Mayo Clinic in FloridaAnne S. Lowery - Vanderbilt UniversitySamir S. Makani - University of California, San DiegoFabien Maldonado - Vanderbilt UniversityKyle Mannion - Vanderbilt UniversityLaura Matrka - The Ohio State UniversityAndrew J. McWhorter - Louisiana State UniversityAlbert L. Merati - University of WashingtonMatthew Mori - New York Eye and Ear InfirmaryJames L. Netterville - Vanderbilt UniversityKarla O'Dell - University of Southern CaliforniaJulina Ongkasuwan - Baylor College of MedicineGregory N. Postma - Augusta UniversityLindsay S. Reder - University of Southern CaliforniaSarah L. Rohde - Vanderbilt UniversityBrent E. Richardson - Bastian Voice Inst, Downers Grove, IL USAOtis B. Rickman - Vanderbilt UniversityClark A. Rosen - University of California, San FranciscoMichael J. Rutter - University of CincinnatiGuri S. Sandhu - Charing Cross HospitalJoshua S. Schindler - Oregon Health & Science UniversityG. Todd Schneider - University of RochesterRupali N. Shah - University of North Carolina at Chapel HillAndrew G. Sikora - Baylor College of MedicineRobert J. Sinard - Vanderbilt UniversityMarshall E. Smith - University of UtahLibby J. Smith - University of PittsburghAhmed M. S. Soliman - Temple UniversitySigriour Sveinsdottir - Landspitali Univ Hosp, Reykjavik, IcelandDouglas J. Van Daele - University of IowaDavid Veivers - Royal North Shore HospitalSunil P. Verma - University of California, IrvinePaul M. Weinberger - Louisiana State University in ShreveportPhilip A. Weissbrod - University of California, San DiegoChristopher T. Wootten - Vanderbilt UniversityYu Shyr - Vanderbilt UniversityDavid O. Francis - University of Wisconsin–MadisonAlexander Gelbard - Vanderbilt University
- Resource Type
- Journal article
- Publication Details
- Annals of otology, rhinology & laryngology, Vol.130(10), pp.1116-1124
- DOI
- 10.1177/0003489421995283
- PMID
- 33629608
- PMCID
- PMC8762607
- NLM abbreviation
- Ann Otol Rhinol Laryngol
- ISSN
- 0003-4894
- eISSN
- 1943-572X
- Publisher
- Sage
- Number of pages
- 9
- Grant note
- 1409-22214 / Patient Centered Outcomes Research Institute; Patient-Centered Outcomes Research Institute - PCORI R01HL146401-01 / National Heart, Lung, and Blood Institute, NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) R21DC016724-01 / National Institute for Deafness and other Communication Disorders, NIH
- Language
- English
- Date published
- 10/01/2021
- Academic Unit
- Radiation Oncology; Medicine Administration; Otolaryngology
- Record Identifier
- 9984311437802771
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