Medical Record Level-Evaluation of Impact of Demographic and Socioeconomic Factors on Pediatric Neuro-Oncology Outcomes at Children's Hospital Colorado.
| العنوان: | Medical Record Level-Evaluation of Impact of Demographic and Socioeconomic Factors on Pediatric Neuro-Oncology Outcomes at Children's Hospital Colorado. |
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| المؤلفون: | Pool A; University of Nebraska Medical Center., Kuna EM; University of Colorado Cancer Center., Anderson-Mellies A; University of Colorado Cancer Center., Kreis A; University of Colorado Anschutz Medical Campus., Marable M; University of Colorado Anschutz Medical Campus., Fraley C; University of Colorado Anschutz Medical Campus., Pacheco D; University of Colorado Cancer Center., Green AL; University of Colorado Anschutz Medical Campus. |
| المصدر: | Research square [Res Sq] 2024 Jan 11. Date of Electronic Publication: 2024 Jan 11. |
| نوع المنشور: | Preprint |
| اللغة: | English |
| بيانات الدورية: | Country of Publication: United States NLM ID: 101768035 Publication Model: Electronic Cited Medium: Internet NLM ISO Abbreviation: Res Sq Subsets: PubMed not MEDLINE |
| مستخلص: | Purpose: A medical record-level cohort study to investigate demographic and socioeconomic factors influencing treatment, timing of care, and survival outcomes in pediatric patients diagnosed with central nervous system (CNS) tumors. Methods: Using electronic health records of patients at Children's Hospital Colorado from 1986-2020, we identified 898 patients treated for CNS tumors. The primary outcomes of interest were 5-year survival, timing of diagnosis, and treatment. Multivariable logistic regression and Cox regression were used to identify covariates associated with our outcomes of interest. Results: We found that age, race, tumor type, diagnosis year, and social concerns influenced receipt and timing of treatment. Age, race, patient rural vs. urban residence, and tumor impacted survival outcomes. Time to presentation and treatment were significantly different between White and minority patients. American Indian/Alaska Native and Black patients were less likely to receive chemo compared to White patients (OR 0.28, 0.93 p = 0.037, < 0.001). Patients with 3 + social concerns were more likely to survive after 5 years than children with no or unknown social concerns (OR 1.84, p = 0.011). However, with an adjusted hazards ratio, children with 2 social concerns were less likely to survive to 5 years than children with no or unknown concerns (OR 0.58, p = 0.066). Conclusions: Demographic and socioeconomic factors influence timing of care and survival outcomes in pediatric patients with CNS tumors. Minority status, age, social factors, rural, and urban patients experience differences in care. This emphasizes the importance of considering these factors and addressing disparities to achieve equitable care. Competing Interests: Declarations Competing Interests: The authors declare no competing interests. |
| References: | Soc Sci Med. 2015 Sep;140:62-8. (PMID: 26204561) JAMA Pediatr. 2015 Dec;169(12):1096-104. (PMID: 26436436) Cancer Causes Control. 2005 Jun;16(5):587-92. (PMID: 15986114) J Interprof Care. 2002 May;16(2):117-28. (PMID: 12028893) N Engl J Med. 2018 Dec 20;379(25):2468-2475. (PMID: 30575483) Cancer. 2008 Nov 1;113(9):2575-96. (PMID: 18837040) Ophthalmology. 2016 Aug;123(8):1817-1823. (PMID: 27262763) Cancer. 2018 Oct 15;124(20):4090-4097. (PMID: 30125340) J Surg Res. 2017 Nov;219:43-49. (PMID: 29078908) Cancer. 2016 Sep 1;122(17):2723-30. (PMID: 27286322) J Neurooncol. 2018 May;138(1):83-97. (PMID: 29417400) Ann Oncol. 2015 Mar;26(3):589-97. (PMID: 25527416) J Neurosurg Pediatr. 2016 Nov;18(5):585-593. (PMID: 27540957) Pediatr Blood Cancer. 2015 Aug;62(8):1337-44. (PMID: 25755225) Cancer. 2018 Oct 15;124(20):3975-3978. (PMID: 30125347) Pediatr Blood Cancer. 2019 Feb;66(2):e27501. (PMID: 30350913) Pediatr Blood Cancer. 2011 Jun;56(6):994-1002. (PMID: 21328525) Sci Rep. 2020 Mar 12;10(1):4588. (PMID: 32165703) Pediatr Blood Cancer. 2021 Jan;68(1):e28738. (PMID: 32970937) J Adolesc Young Adult Oncol. 2019 Jun;8(3):227-235. (PMID: 30676208) J Neurooncol. 2021 May;152(3):451-466. (PMID: 33774801) Cancer Epidemiol. 2020 Feb;64:101644. (PMID: 31783249) |
| معلومات مُعتمدة: | P30 CA046934 United States CA NCI NIH HHS |
| فهرسة مساهمة: | Keywords: diagnostic timing; disparities; pediatric CNS tumors; survival; treatment |
| تواريخ الأحداث: | Date Created: 20240123 Latest Revision: 20240212 |
| رمز التحديث: | 20240212 |
| مُعرف محوري في PubMed: | PMC10802725 |
| DOI: | 10.21203/rs.3.rs-3849043/v1 |
| PMID: | 38260550 |
| قاعدة البيانات: | MEDLINE |
| DOI: | 10.21203/rs.3.rs-3849043/v1 |
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