Article ; Online: The Impact of Social Determinants of Health on Vestibular Schwannoma Management: A Single Institution Review.
2023 Volume 44, Issue 5, Page(s) 507–512
Abstract: Objective: To evaluate social determinants of health and their effect on the management of vestibular schwannoma (VS).: Study design: Retrospective chart review.: Setting: Tertiary referral center.: Patients: Patients >18 years old with ... ...
Abstract | Objective: To evaluate social determinants of health and their effect on the management of vestibular schwannoma (VS). Study design: Retrospective chart review. Setting: Tertiary referral center. Patients: Patients >18 years old with sporadic VS newly diagnosed between January 1, 2010, and December 31, 2020. Interventions: Magnetic resonance imaging; audiogram; treatment recommendations. Main outcome measures: Differences in treatment recommendations for patients based on their social determinants of health, including race, ethnicity, and socioeconomic status. Results: A total of 811 patients were included in analysis. Patients with a higher area deprivation index (ADI) presented with larger tumors. A higher ADI was associated with a higher likelihood of recommending radiation (or the option of surgery or radiation) compared with a recommendation of surgery alone. Tumor grade and patient age were significantly associated with treatment recommendation. Older age was associated with a recommendation of observation alone or a recommendation of radiation. Higher tumor grade was associated with a recommendation of surgery. There was a trend for higher hearing class to be associated with a recommendation of surgery, but this did not reach statistical significance. Race, ethnicity, and gender were not significantly associated with treatment recommendation. Conclusions: Patients with higher levels of disadvantage presented with higher tumor grade, suggesting that access to care influences diagnosis. Factors including age, ADI, and tumor grade were associated with treatment recommendation. |
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MeSH term(s) | Humans ; Adolescent ; Neuroma, Acoustic/surgery ; Retrospective Studies ; Social Determinants of Health ; Hearing ; Hearing Tests ; Treatment Outcome |
Language | English |
Publishing date | 2023-03-30 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 2036790-9 |
ISSN | 1537-4505 ; 1531-7129 |
ISSN (online) | 1537-4505 |
ISSN | 1531-7129 |
DOI | 10.1097/MAO.0000000000003883 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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