Geographic Access Disparities to Clinical Trials in Retinopathy of Prematurity in the United States

Abstract

Background/Purpose: To identify geographic and socioeconomic variables predictive of residential proximity to retinopathy of prematurity (ROP) clinical trial locations.Methods: This cross-sectional epidemiological study used census tract-level data from three national public data sets and trial-level data from ClinicalTrials.gov. Socioeconomic predictors of driving distance and time to the nearest ROP clinical trial location were identified. Primary outcomes were time .60 minutes and distance .60 miles traveled to the nearest ROP clinical trial site.Results: Multivariate analysis showed that residents were more likely to travel .60 minutes to the nearest ROP clinical trial site if they lived in census tracts that were rural (adjusted odds ratio 1.20, P = 0.0002), had higher percentages of the population living # federal poverty level (fourth quartile vs. first quartile, adjusted odds ratio 1.19, P , 0.0001), or had less education (associate vs. bachelor's degree, adjusted odds ratio 1.01, P ,0.007). By contrast, counties with higher percentages of births with birth weight ,1500 g (adjusted odds ratio 0.88, P = 0.0062) were less likely to travel .60 minutes. Similar variables predicted travel distance.Conclusion: Although counties with higher incidences of very low-birth-weight infants were closer to ROP clinical trial sites, residents living in rural and low-income census tracts had significantly greater travel burdens.

Epidemiology of Retinopathy of Prematurity in the US From 2003 to 2019

“…People living in rural and low-income areas usually need to travel significantly farther to access ROP clinical trial sites, which often represent care centers. 18 Access to both the expertise and resources necessary for ROP screening and treatment is not equitably distributed across the US, and populations facing greater barriers to care are also often the groups likely to be most affected by ROP. Although telemedicine may improve access to care for vulnerable patient populations, its applications still mostly pertain to screening.…”

“…Regardless of region, the burden of ROP seems to have shifted from rural hospitals to urban ones, although this trend could also be explained by poorer screening in rural areas. People living in rural and low-income areas usually need to travel significantly farther to access ROP clinical trial sites, which often represent care centers . Access to both the expertise and resources necessary for ROP screening and treatment is not equitably distributed across the US, and populations facing greater barriers to care are also often the groups likely to be most affected by ROP.…”

Comparative Analysis Reveals Novel Changes in Plasma Metabolites and Metabolomic Networks of Infants With Retinopathy of Prematurity

“… 4 , 5 A recent epidemiological study reported that approximately 100,000 children with ROP have been diagnosed worldwide. 2 , 6 …”

The evolving field of Big Data: understanding geographic information systems analysis and its transformative potential in ophthalmic research

“…A few studies in recent years have used this geographic analysis of ophthalmic accessibility. In several studies of accessibility to clinical trials in ophthalmology, Soares et al [45] looked at the travel time and distance between the centroid of each of the roughly 72000 census tracts in the United States to the nearest clinical trial site in diabetic eye disease, age-related macular degeneration [46], and retinopathy of prematurity [47]. The studies used GIS software (ArcGIS, Esri, Redlands, California, USA) [48] to construct origin-destination cost-matrices.…”