Jaclyn Lee1, Li-Ching Huang2, Lynn D Berry2, Catherine Anderson3, Milan R Amin4, Michael S Benninger5, Joel H Blumin6, Jonathan M Bock6, Paul C Bryson5, Paul F Castellanos7, Sheau-Chiann Chen2, Matthew S Clary8, Seth M Cohen9, Brianna K Crawley10, Seth H Dailey10, James J Daniero11, Alessandro de Alarcon12, Donald T Donovan13, Eric S Edell14, Dale C Ekbom15, Daniel S Fink8, Ramon A Franco16, C Gaelyn Garrett1, Elizabeth A Guardiani17, Alexander T Hillel18, Henry T Hoffman19, Norman D Hogikyan20, Rebecca J Howell12, Lena K Hussain2, Michael M Johns21, Jan L Kasperbauer15, Sid M Khosla12, Cheryl Kinnard2, Robbi A Kupfer20, Alexander J Langerman2, Robert J Lentz2, Robert R Lorenz6, David G Lott22, Anne S Lowery1, Samir S Makani23, Fabien Maldonado1, Kyle Mannion1, Laura Matrka24, Andrew J McWhorter25, Albert L Merati26, Matthew Mori27, James L Netterville1, Karla O'Dell21, Julina Ongkasuwan13, Gregory N Postma28, Lindsay S Reder21, Sarah L Rohde1, Brent E Richardson29, Otis B Rickman30, Clark A Rosen31, Michael J Rutter12, Guri S Sandhu32, Joshua S Schindler33, G Todd Schneider34, Rupali N Shah35, Andrew G Sikora13, Robert J Sinard1, Marshall E Smith36, Libby J Smith37, Ahmed M S Soliman38, Sigríður Sveinsdóttir39, Douglas J Van Daele19, David Veivers40, Sunil P Verma41, Paul M Weinberger42, Philip A Weissbrod43, Christopher T Wootten1, Yu Shyr2, David O Francis44, Alexander Gelbard1. 1. Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. 2. Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA. 3. Australian Market and Social Research Society, Glebe, NSW, Australia. 4. NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, USA. 5. Department of Otolaryngology-Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA. 6. Division of Laryngology and Professional Voice, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA. 7. Division of Otolaryngology, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. 8. Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Denver, CO, USA. 9. Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA. 10. Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA. 11. Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA. 12. Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA. 13. Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA. 14. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. 15. Department of Otolaryngology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. 16. Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. 17. Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA. 18. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institution, Baltimore, MD, USA. 19. Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. 20. Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA. 21. Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA, USA. 22. Department of Otorhinolaryngology, Mayo Clinic Scottsdale, Scottsdale, AZ, USA. 23. Division of Pulmonary and Critical Care Medicine, University of California, San Diego, San Diego, CA, USA. 24. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA. 25. Department of Otolaryngology, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA, USA. 26. Department of Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, WA, USA. 27. Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY USA. 28. Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, USA. 29. Bastian Voice Institute, Downers Grove, IL, USA. 30. Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. 31. Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, USA. 32. National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. 33. Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Northwest Clinic for Voice and Swallowing, Portland, OR, USA. 34. Department of Otolaryngology, University of Rochester, Rochester, NY, USA. 35. Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 36. Division of Otolaryngology-Head and Neck Surgery, The University of Utah, Salt Lake City, UT, USA. 37. Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, PA, USA. 38. Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA. 39. Landspítali University Hospital, Reykjavik, Iceland. 40. Department of Otolaryngology-Head and Neck Surgery, Royal North Shore Hospital, Sydney, NSW, Australia. 41. Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA, USA. 42. Departments of Otolaryngology, Molecular and Cellular Physiology, Feist-Weiller Cancer Center, LSU Shreveport, LA, USA. 43. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, San Diego, CA, USA. 44. Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, WI, USA.
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.
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.
Entities:
Keywords:
education; iSGS; income; social support; surgical outcomes; time to diagnosis
Authors: Matthew Pantell; David Rehkopf; Douglas Jutte; S Leonard Syme; John Balmes; Nancy Adler Journal: Am J Public Health Date: 2013-09-12 Impact factor: 9.308
Authors: Sabina Dang; Justin R Shinn; Benjamin R Campbell; Gaelyn Garrett; Christopher Wootten; Alexander Gelbard Journal: Laryngoscope Date: 2019-07-29 Impact factor: 3.325
Authors: Amie L Meditz; Samantha MaWhinney; Amanda Allshouse; William Feser; Martin Markowitz; Susan Little; Richard Hecht; Eric S Daar; Ann C Collier; Joseph Margolick; J Michael Kilby; Jean-Pierre Routy; Brian Conway; John Kaldor; Jay Levy; Robert Schooley; David A Cooper; Marcus Altfeld; Douglas Richman; Elizabeth Connick Journal: J Infect Dis Date: 2011-01-18 Impact factor: 5.226
Authors: Edward P Havranek; Mahasin S Mujahid; Donald A Barr; Irene V Blair; Meryl S Cohen; Salvador Cruz-Flores; George Davey-Smith; Cheryl R Dennison-Himmelfarb; Michael S Lauer; Debra W Lockwood; Milagros Rosal; Clyde W Yancy Journal: Circulation Date: 2015-08-03 Impact factor: 29.690