Health care disparities and chronic rhinosinusitis : Does neighborhood disadvantage impact outcomes in sinonasal disease?
© 2024 The Authors. International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society..
OBJECTIVE: Socioeconomic status (SES) is linked to health outcomes but has not been well studied in patients with chronic rhinosinusitis (CRS). The area deprivation index (ADI) is a comprehensive measure of geographic SES that ranks neighborhood disadvantage. This investigation used ADI to understand the impact of neighborhood disadvantage on CRS treatment outcomes.
METHODS: A total of 642 study participants with CRS were prospectively enrolled and self-selected endoscopic sinus surgery (ESS) or continued appropriate medical therapy as treatment. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility value scores were recorded pre- and post-treatment. Using residence zip codes, national ADI scores were retrospectively assigned to patients. Spearman's correlation coefficients (Rs) and Cramer's V effect size (φc ) with 95% confidence interval (CI) were calculated.
RESULTS: A history of ESS was associated with significantly worse ADI scores compared to no history of ESS (φc = 0.18; 95% CI: 0.10, 0.25; p < 0.001). Baseline total SNOT-22 (Rs = 0.14; 95% CI: 0.06, 0.22; p < 0.001) and SF-6D values (Rs = -0.20; 95% CI: -0.27, -0.12; p < 0.001) were significantly negatively correlated with national ADI rank. No significant correlations between ADI and within-subject improvement, or achievement of >1 minimal clinically important difference, in SNOT-22 or SF-6D scores after treatment were found.
CONCLUSIONS: Geographic socioeconomic deprivation was associated with worse baseline disease severity and history of prior surgical intervention. However, ADI did not correlate with improvement in disease-specific outcomes. The impact of socioeconomic deprivation on outcomes in CRS requires further investigation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
International forum of allergy & rhinology - (2024) vom: 17. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gill, Amarbir S [VerfasserIn] |
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| Links: |
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| Themen: |
Chronic rhinosinusitis |
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| Anmerkungen: |
Date Revised 17.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1002/alr.23337 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368573168 |
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| 100 | 1 | |a Gill, Amarbir S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Health care disparities and chronic rhinosinusitis |b Does neighborhood disadvantage impact outcomes in sinonasal disease? |
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| 520 | |a © 2024 The Authors. International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society. | ||
| 520 | |a OBJECTIVE: Socioeconomic status (SES) is linked to health outcomes but has not been well studied in patients with chronic rhinosinusitis (CRS). The area deprivation index (ADI) is a comprehensive measure of geographic SES that ranks neighborhood disadvantage. This investigation used ADI to understand the impact of neighborhood disadvantage on CRS treatment outcomes | ||
| 520 | |a METHODS: A total of 642 study participants with CRS were prospectively enrolled and self-selected endoscopic sinus surgery (ESS) or continued appropriate medical therapy as treatment. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility value scores were recorded pre- and post-treatment. Using residence zip codes, national ADI scores were retrospectively assigned to patients. Spearman's correlation coefficients (Rs) and Cramer's V effect size (φc ) with 95% confidence interval (CI) were calculated | ||
| 520 | |a RESULTS: A history of ESS was associated with significantly worse ADI scores compared to no history of ESS (φc = 0.18; 95% CI: 0.10, 0.25; p < 0.001). Baseline total SNOT-22 (Rs = 0.14; 95% CI: 0.06, 0.22; p < 0.001) and SF-6D values (Rs = -0.20; 95% CI: -0.27, -0.12; p < 0.001) were significantly negatively correlated with national ADI rank. No significant correlations between ADI and within-subject improvement, or achievement of >1 minimal clinically important difference, in SNOT-22 or SF-6D scores after treatment were found | ||
| 520 | |a CONCLUSIONS: Geographic socioeconomic deprivation was associated with worse baseline disease severity and history of prior surgical intervention. However, ADI did not correlate with improvement in disease-specific outcomes. The impact of socioeconomic deprivation on outcomes in CRS requires further investigation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a FESS | |
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| 650 | 4 | |a quality of life | |
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| 700 | 1 | |a Massey, Conner |e verfasserin |4 aut | |
| 700 | 1 | |a Pandrangi, Vivek C |e verfasserin |4 aut | |
| 700 | 1 | |a Gutierrez, Jorge A |e verfasserin |4 aut | |
| 700 | 1 | |a Ramakrishnan, Vijay R |e verfasserin |4 aut | |
| 700 | 1 | |a Beswick, Daniel M |e verfasserin |4 aut | |
| 700 | 1 | |a Soler, Zachary M |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Timothy L |e verfasserin |4 aut | |
| 700 | 1 | |a Alt, Jeremiah A |e verfasserin |4 aut | |
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