@article{b85dd1ed09f44b27929dbd14e74a127e,
title = "Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis",
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.",
keywords = "education, iSGS, income, social support, surgical outcomes, time to diagnosis",
author = "Jaclyn Lee and Huang, {Li Ching} and Berry, {Lynn D.} and Catherine Anderson and Amin, {Milan R.} and Benninger, {Michael S.} and Blumin, {Joel H.} and Bock, {Jonathan M.} and Bryson, {Paul C.} and Castellanos, {Paul F.} and Chen, {Sheau Chiann} and Clary, {Matthew S.} and Cohen, {Seth M.} and Crawley, {Brianna K.} and Dailey, {Seth H.} and Daniero, {James J.} and {de. Alarcon}, Alessandro and Donovan, {Donald T.} and Edell, {Eric S.} and Ekbom, {Dale C.} and Fink, {Daniel S.} and Franco, {Ramon A.} and Garrett, {C. Gaelyn} and Guardiani, {Elizabeth A.} and Hillel, {Alexander T.} and Hoffman, {Henry T.} and Hogikyan, {Norman D.} and Howell, {Rebecca J.} and Hussain, {Lena K.} and Johns, {Michael M.} and Kasperbauer, {Jan L.} and Khosla, {Sid M.} and Cheryl Kinnard and Kupfer, {Robbi A.} and Langerman, {Alexander J.} and Lentz, {Robert J.} and Lorenz, {Robert R.} and Lott, {David G.} and Lowery, {Anne S.} and Makani, {Samir S.} and Fabien Maldonado and Kyle Mannion and Laura Matrka and McWhorter, {Andrew J.} and Merati, {Albert L.} and Matthew Mori and Netterville, {James L.} and Karla O{\textquoteright}Dell and Julina Ongkasuwan and Postma, {Gregory N.} and Reder, {Lindsay S.} and Rohde, {Sarah L.} and Richardson, {Brent E.} and Rickman, {Otis B.} and Rosen, {Clark A.} and Rutter, {Michael J.} and Sandhu, {Guri S.} and Schindler, {Joshua S.} and Schneider, {G. Todd} and Shah, {Rupali N.} and Sikora, {Andrew G.} and Sinard, {Robert J.} and Smith, {Marshall E.} and Smith, {Libby J.} and Soliman, {Ahmed M.S.} and Sigr{\'i}{\dh}ur Sveinsd{\'o}ttir and {Van Daele}, {Douglas J.} and David Veivers and Verma, {Sunil P.} and Weinberger, {Paul M.} and Weissbrod, {Philip A.} and Wootten, {Christopher T.} and Yu Shyr and Francis, {David O.} and Alexander Gelbard",
note = "Funding Information: This work was supported by funding from the Patient Centered Outcomes Research Institute (PCORI): Grant ID:1409-22214. Dr. Gelbard is also supported by grant R01HL146401-01 from the National Heart, Lung, and Blood Institute, NIH. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by grant 1409-22214 from the Patient Centered Outcomes Research Institute. AG is also supported by grant R01HL146401-01 from the National Heart, Lung, and Blood Institute, NIH. DOF is supported by grant R21DC016724-01 from the National Institute for Deafness and other Communication Disorders, NIH. The funding entities had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, approval, or decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} The Author(s) 2021.",
year = "2021",
month = oct,
doi = "10.1177/0003489421995283",
language = "English (US)",
volume = "130",
pages = "1116--1124",
journal = "Annals of Otology, Rhinology and Laryngology",
issn = "0003-4894",
publisher = "Annals Publishing Company",
number = "10",
}