Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis.

Jaclyn Lee; Li-Ching Huang; Lynn D Berry; Catherine Anderson; Milan R Amin; Michael S Benninger; Joel H Blumin; Jonathan M Bock; Paul C Bryson; Paul F Castellanos; Sheau-Chiann Chen; Matthew S Clary; Seth M Cohen; Brianna K Crawley; Seth H Dailey; James J Daniero; Alessandro de Alarcon; Donald T Donovan; Eric S Edell; Dale C Ekbom; Daniel S Fink; Ramon A Franco; C Gaelyn Garrett; Elizabeth A Guardiani; Alexander T Hillel; Henry T Hoffman; Norman D Hogikyan; Rebecca J Howell; Lena K Hussain; Michael M Johns; Jan L Kasperbauer; Sid M Khosla; Cheryl Kinnard; Robbi A Kupfer; Alexander J Langerman; Robert J Lentz; Robert R Lorenz; David G Lott; Anne S Lowery; Samir S Makani; Fabien Maldonado; Kyle Mannion; Laura Matrka; Andrew J McWhorter; Albert L Merati; Matthew Mori; James L Netterville; Karla O'Dell; Julina Ongkasuwan; Gregory N Postma; Lindsay S Reder; Sarah L Rohde; Brent E Richardson; Otis B Rickman; Clark A Rosen; Michael J Rutter; Guri S Sandhu; Joshua S Schindler; G Todd Schneider; Rupali N Shah; Andrew G Sikora; Robert J Sinard; Marshall E Smith; Libby J Smith; Ahmed M S Soliman; Sigríður Sveinsdóttir; Douglas J Van Daele; David Veivers; Sunil P Verma; Paul M Weinberger; Philip A Weissbrod; Christopher T Wootten; Yu Shyr; David O Francis; Alexander Gelbard

doi:10.1177/0003489421995283

Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis.

Jaclyn Lee, Li-Ching Huang, Lynn D Berry, Catherine Anderson, Milan R Amin, Michael S Benninger, Joel H Blumin, Jonathan M Bock, Paul C Bryson, Paul F Castellanos, Sheau-Chiann Chen, Matthew S Clary, Seth M Cohen, Brianna K Crawley, Seth H Dailey, James J Daniero, Alessandro de Alarcon, Donald T Donovan, Eric S Edell, Dale C EkbomDaniel S Fink, Ramon A Franco, C Gaelyn Garrett, Elizabeth A Guardiani, Alexander T Hillel, Henry T Hoffman, Norman D Hogikyan, Rebecca J Howell, Lena K Hussain, Michael M Johns, Jan L Kasperbauer, Sid M Khosla, Cheryl Kinnard, Robbi A Kupfer, Alexander J Langerman, Robert J Lentz, Robert R Lorenz, David G Lott, Anne S Lowery, Samir S Makani, Fabien Maldonado, Kyle Mannion, Laura Matrka, Andrew J McWhorter, Albert L Merati, Matthew Mori, James L Netterville, Karla O'Dell, Julina Ongkasuwan, Gregory N Postma, Lindsay S Reder, Sarah L Rohde, Brent E Richardson, Otis B Rickman, Clark A Rosen, Michael J Rutter, Guri S Sandhu, Joshua S Schindler, G Todd Schneider, Rupali N Shah, Andrew G Sikora, Robert J Sinard, Marshall E Smith, Libby J Smith, Ahmed M S Soliman, Sigríður Sveinsdóttir, Douglas J Van Daele, David Veivers, Sunil P Verma, Paul M Weinberger, Philip A Weissbrod, Christopher T Wootten, Yu Shyr, David O Francis, Alexander Gelbard

Landspitali - The National University Hospital of Iceland

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	1116-1124
Journal	The Annals of otology, rhinology, and laryngology
Volume	130
Issue number	10
DOIs	https://doi.org/10.1177/0003489421995283
Publication status	Published - 25 Feb 2021

Other keywords

education
iSGS
income
social support
surgical outcomes
time to diagnosis
Laryngostenosis
Social Determinants of Health
Treatment Outcome

Access to Document

10.1177/0003489421995283

https://journals.sagepub.com/doi/10.1177/0003489421995283?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

Cite this

Lee, J., Huang, L-C., Berry, L. D., Anderson, C., Amin, M. R., Benninger, M. S., Blumin, J. H., Bock, J. M., Bryson, P. C., Castellanos, P. F., Chen, S-C., Clary, M. S., Cohen, S. M., Crawley, B. K., Dailey, S. H., Daniero, J. J., de Alarcon, A., Donovan, D. T., Edell, E. S., ... Gelbard, A. (2021). Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis. The Annals of otology, rhinology, and laryngology, 130(10), 1116-1124. https://doi.org/10.1177/0003489421995283

@article{d4ed4581cc65422591c5a7e59b023cd1,

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, Laryngostenosis, Social Determinants of Health, Treatment Outcome, education, iSGS, income, social support, surgical outcomes, time to diagnosis, Laryngostenosis, Social Determinants of Health, Treatment Outcome",

author = "Jaclyn Lee and Li-Ching Huang 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 Sheau-Chiann Chen 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'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",

year = "2021",

month = feb,

day = "25",

doi = "10.1177/0003489421995283",

language = "English",

volume = "130",

pages = "1116--1124",

journal = "Annals of Otology, Rhinology and Laryngology",

issn = "0003-4894",

publisher = "Sage Publications",

number = "10",

}

Lee, J, Huang, L-C, Berry, LD, Anderson, C, Amin, MR, Benninger, MS, Blumin, JH, Bock, JM, Bryson, PC, Castellanos, PF, Chen, S-C, Clary, MS, Cohen, SM, Crawley, BK, Dailey, SH, Daniero, JJ, de Alarcon, A, Donovan, DT, Edell, ES, Ekbom, DC, Fink, DS, Franco, RA, Garrett, CG, Guardiani, EA, Hillel, AT, Hoffman, HT, Hogikyan, ND, Howell, RJ, Hussain, LK, Johns, MM, Kasperbauer, JL, Khosla, SM, Kinnard, C, Kupfer, RA, Langerman, AJ, Lentz, RJ, Lorenz, RR, Lott, DG, Lowery, AS, Makani, SS, Maldonado, F, Mannion, K, Matrka, L, McWhorter, AJ, Merati, AL, Mori, M, Netterville, JL, O'Dell, K, Ongkasuwan, J, Postma, GN, Reder, LS, Rohde, SL, Richardson, BE, Rickman, OB, Rosen, CA, Rutter, MJ, Sandhu, GS, Schindler, JS, Schneider, GT, Shah, RN, Sikora, AG, Sinard, RJ, Smith, ME, Smith, LJ, Soliman, AMS, Sveinsdóttir, S, Van Daele, DJ, Veivers, D, Verma, SP, Weinberger, PM, Weissbrod, PA, Wootten, CT, Shyr, Y, Francis, DO & Gelbard, A 2021, 'Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis.', The Annals of otology, rhinology, and laryngology, vol. 130, no. 10, pp. 1116-1124. https://doi.org/10.1177/0003489421995283

TY - JOUR

T1 - Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis.

AU - Lee, Jaclyn

AU - Huang, Li-Ching

AU - Berry, Lynn D

AU - Anderson, Catherine

AU - Amin, Milan R

AU - Benninger, Michael S

AU - Blumin, Joel H

AU - Bock, Jonathan M

AU - Bryson, Paul C

AU - Castellanos, Paul F

AU - Chen, Sheau-Chiann

AU - Clary, Matthew S

AU - Cohen, Seth M

AU - Crawley, Brianna K

AU - Dailey, Seth H

AU - Daniero, James J

AU - de Alarcon, Alessandro

AU - Donovan, Donald T

AU - Edell, Eric S

AU - Ekbom, Dale C

AU - Fink, Daniel S

AU - Franco, Ramon A

AU - Garrett, C Gaelyn

AU - Guardiani, Elizabeth A

AU - Hillel, Alexander T

AU - Hoffman, Henry T

AU - Hogikyan, Norman D

AU - Howell, Rebecca J

AU - Hussain, Lena K

AU - Johns, Michael M

AU - Kasperbauer, Jan L

AU - Khosla, Sid M

AU - Kinnard, Cheryl

AU - Kupfer, Robbi A

AU - Langerman, Alexander J

AU - Lentz, Robert J

AU - Lorenz, Robert R

AU - Lott, David G

AU - Lowery, Anne S

AU - Makani, Samir S

AU - Maldonado, Fabien

AU - Mannion, Kyle

AU - Matrka, Laura

AU - McWhorter, Andrew J

AU - Merati, Albert L

AU - Mori, Matthew

AU - Netterville, James L

AU - O'Dell, Karla

AU - Ongkasuwan, Julina

AU - Postma, Gregory N

AU - Reder, Lindsay S

AU - Rohde, Sarah L

AU - Richardson, Brent E

AU - Rickman, Otis B

AU - Rosen, Clark A

AU - Rutter, Michael J

AU - Sandhu, Guri S

AU - Schindler, Joshua S

AU - Schneider, G Todd

AU - Shah, Rupali N

AU - Sikora, Andrew G

AU - Sinard, Robert J

AU - Smith, Marshall E

AU - Smith, Libby J

AU - Soliman, Ahmed M S

AU - Sveinsdóttir, Sigríður

AU - Van Daele, Douglas J

AU - Veivers, David

AU - Verma, Sunil P

AU - Weinberger, Paul M

AU - Weissbrod, Philip A

AU - Wootten, Christopher T

AU - Shyr, Yu

AU - Francis, David O

AU - Gelbard, Alexander

PY - 2021/2/25

Y1 - 2021/2/25

N2 - 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.

AB - 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.

KW - education

KW - iSGS

KW - income

KW - social support

KW - surgical outcomes

KW - time to diagnosis

KW - Laryngostenosis

KW - Social Determinants of Health

KW - Treatment Outcome

KW - education

KW - iSGS

KW - income

KW - social support

KW - surgical outcomes

KW - time to diagnosis

KW - Laryngostenosis

KW - Social Determinants of Health

KW - Treatment Outcome

U2 - 10.1177/0003489421995283

DO - 10.1177/0003489421995283

M3 - Article

C2 - 33629608

SN - 0003-4894

VL - 130

SP - 1116

EP - 1124

JO - Annals of Otology, Rhinology and Laryngology

JF - Annals of Otology, Rhinology and Laryngology

IS - 10

ER -

Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis.

Abstract

Other keywords

Access to Document

Fingerprint

Cite this