Recent Epidemiology of Pediatric Cochlear Implantation in the United States: Disparity Among Children of Different Ethnicity and Socioeconomic Status

Stern, Ryan E.; Yueh, Bevan; Lewis, Carol; Norton, Susan J.; Sie, Kathleen C.Y.

doi:10.1097/01.mlg.0000150698.61624.3c

Cited by 84 publications

(99 citation statements)

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“…Information on net yearly income was used from 1999. The use of information on SES with zip codes has been reported in other studies as well (Franks and Fiscella, 2002;Franks et al, 2003;Yoo and Thuluvath, 2004;Stern et al, 2005).…”

Section: Socio-economic Statusmentioning

confidence: 84%

The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands

et al. 2006

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In the United States (USA), a correlation has been demonstrated between socio-economic status (SES) of patients on the one hand, and tumour histology, stage of the disease and treatment modality of various cancer types on the other hand. It is unknown whether such correlations are also involved in patients with oesophageal cancer in The Netherlands. Between 1994 and 2003, 888 oesophageal cancer patients were included in a prospective database with findings on the diagnostic work-up and treatment of oesophageal cancer. Socio-economic status of patients was defined as the average net yearly income. Linear-by-linear association testing revealed that oesophageal adenocarcinoma was more frequently observed in patients with higher SES and squamous cell carcinoma in patients with lower SES (P ¼ 0.02). Multivariable logistic regression analysis showed no correlation between SES and staging procedures and preoperative TNM stage. The adjusted odds ratio (OR) for stent placement was 0.82 (95% CI 0.71 -0.95), indicating that with an increase in SES by 1200 h, the likelihood that a stent was placed declined by 18%. Patients with a higher SES more frequently underwent resection or were treated with chemotherapy (OR: 1.15; 95% CI 1.01 -1.32 and OR: 1.16; 95% CI 1.02 -1.32, respectively). Socio-economic factors are involved in oesophageal cancer in The Netherlands, as patients with a higher SES are more likely to have an adenocarcinoma and patients with a lower SES a squamous cell carcinoma. Moreover, the correlations between SES and different treatment modalities suggest that both patient and doctor determinants contribute to the decision on the most optimal treatment modality in patients with oesophageal cancer.

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Section: Socio-economic Statusmentioning

confidence: 84%

The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands

et al. 2006

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“…Such a relatively high age at implantation in our cases can be attributed to many factors, including lack of newborn hearing screening, failure of the parents/family to respond early to the condition, or low socioeconomic state and/or presence of financial barriers and decreased public awareness. A study done by Stern et al [8] revealed that patients from lower-income families had lower rates of implantation compared with higher-income groups. We also revealed that children with higher age at implantation were associated with a higher expressive language age 1 year postimplantation.…”

Section: Discussionmentioning

confidence: 99%

Statistical Analysis of Various Factors Affecting the Results of Cochlear Implantation

Zohdi¹,

AbdelMessih²,

Maged³

et al. 2014

Int Adv Otol

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OBJECTIVE:Evaluation of several factors that affected the outcome in patients who underwent cochlear implant surgery. MATERIALS and METHODS:Retrospective study on 8 postlingual adults and 52 prelingual children with severe to profound hearing loss who underwent cochlear implantation at the Otolaryngology-Head and Neck surgery department, Kasr-Al Aini Hospital, Cairo University. A statistical analysis of several factors was performed to reveal any significant effect of the outcome of the procedure. RESULTS:The duration of deafness in adults showed a significant linear yet non-monotonic correlation with the postoperative average auditory thresholds as revealed by Pearson's correlation coefficient (r=0.839, p=0.009) and a linear regression model (f=14.211, p=0.009), which showed that the increase in the duration of deafness led to an increase in hearing thresholds and accounted for 70.3% of the variance in the outcome (β=0.839, t=3.770, and p=0.009). Age at implantation in children showed a positive linear, monotonic relation with the postoperative receptive (r=0.725, p<0.001, r S =0.354, p=0.010) and was a significant predictor of outcome (β=0.440, t=2.961; p=0.005) according to multiple linear regression. Mann-Whitney U-test was performed to evaluate the difference in medians of outcomes in relation to the regularity of attendance to speech rehabilitation. We found a significant effect over the auditory hearing thresholds (the mean ranks of regulars and irregulars were 21. 48 and 31.92, respectively; u=202.00, z=2.48, p<0.05) CONCLUSION: An increase in the duration of deafness leads to less favorable results of postoperative auditory thresholds in postlingual adults. Additionally, an increase in age at implantation may be associated with increased expressive language age in the first year postimplantation, and regular attendance to a speech rehabilitation program is associated with better postoperative auditory thresholds and a higher receptive language age.

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“…Not only in South Africa, but all over the world many areas of healthcare are replete with evidence of socioeconomic status and ethnicity related disparities, with pediatric cochlear implantation being no exception [75][76][77]. The current study population consisted of predominantly Caucasian (62%) children from the private health care system (95%), speaking either Afrikaans (46%) or English (43%).…”

Section: Discussionmentioning

confidence: 99%

Predictors of pediatric cochlear implantation outcomes in South Africa

Roux

Vinck

Butler

et al. 2016

International Journal of Pediatric Otorhinolaryngology

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Objective: To identify and describe predictors of pediatric cochlear implantation outcomes in a South African population. Methods:A retrospective study of 301 pediatric CI recipients from five cochlear implant programs was conducted and cross-sectional outcome data were added at the time of data collection. Twenty potential prognostic factors were identified from the retrospective dataset, including biographical, cochlear implant (CI), family and risk factors. Multiple regression analyses was performed to identify predictor variables that influence outcomes in terms of auditory performance (CAP scores), speech production (SIR scores), communication mode and educational placement.Results: Although implanted children within this sample did not have equal opportunity to access a second implant, bilateral implantation was strongly predictive of better auditory performance and speech production scores, an oral mode of communication and mainstream education. NICU admittance/ prematurity were associated with poorer auditory performance and speech production scores, together with a higher probability for non-oral communication and non-mainstream education. The presence of one or more additional developmental 2 condition was predictive of poorer outcomes in terms of speech production and educational placement, while a delay between diagnosis and implantation of more than one year was also related to non-mainstream education. Ethnicities other than Caucasian were predictive of poorer auditory performance scores and a lower probability for mainstream education.Conclusion: An extensive range of prognostic indicators were identified for pediatric CI outcomes in South Africa. These predictive factors of better and poorer outcomes should guide pediatric CI services to promote optimal outcomes and assist professionals in providing evidence-based informational counselling.

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Recent Epidemiology of Pediatric Cochlear Implantation in the United States: Disparity Among Children of Different Ethnicity and Socioeconomic Status

Cited by 84 publications

References 10 publications

The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands

The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands

Statistical Analysis of Various Factors Affecting the Results of Cochlear Implantation

Predictors of pediatric cochlear implantation outcomes in South Africa

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