Evidence map›Paper›PMID 38632134›Full record

ArticlePediatric radiology2024

Sociodemographic factors and Child Opportunity Index disparities associated with missed care opportunities in pediatric patients with lymphoma and leukemia referred for FDG-PET/CT.

Samantha Harrington, Neha Kwatra, Patrice Melvin, Ashley B Tartarilla, Melicia Y Whitley, Valentina Ferrer Valencia, Valerie L Ward

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Article in Pediatric radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Samantha Harrington *Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Neha Kwatra *Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA. neha.kwatra@childrens.harvard.edu.ORCID 0000-0002-9686-3550
Patrice MelvinSandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA.
Ashley B TartarillaSandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA.
Melicia Y WhitleySandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA.
Valentina Ferrer ValenciaDepartment of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
Valerie L WardDepartment of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.

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6 · The paper itself

Abstract

backgroundLittle data exists on the association of missed care opportunities (MCOs) in children referred for nuclear medicine/nuclear oncology imaging examinations and socioeconomic disparities.

objectiveTo determine the prevalence of MCOs in children with lymphoma/leukemia scheduled for fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and the impact of sociodemographic factors and Child Opportunity Index (COI). MATERIALS AND

methodsRetrospective analysis of MCOs in children with lymphoma/leukemia scheduled for FDG-PET/CT (2012 to 2022) was performed. In univariate analysis, patient, neighborhood, and appointment data were assessed across MCOs and completed appointments. Logistic regression evaluated independent effects of patient-, neighborhood-, and appointment-level factors with MCOs. Two-sided P-value < .05 was considered statistically significant.

resultsIn 643 FDG-PET/CT appointments (n = 293 patients; median age 15 years (IQR 11.0-17.0 years); 37.9% female), there were 20 MCOs (3.1%) involving 16 patients. Only 8.2% appointments involved Black/African American non-Hispanic/Latino patients, yet they made up a quarter of total MCOs. Patients living in neighborhoods with very low or low COI experienced significantly higher MCOs versus zip codes with very high COI (6.9% vs. 0.8%; P = 0.02). Logistic regression revealed significantly increased likelihood of MCOs for patients aged 18 to 21 [odds ratio (OR) 4.50; 95% CI 1.53-13.27; P = 0.007], Black/African American non-Hispanic/Latino (OR 3.20; 95% CI 1.08-9.49; P = 0.04), zip codes with very low or low COI (OR 9.60; 95% CI 1.24-74.30; P = 0.03), and unknown insurance status.

conclusionChildren with lymphoma/leukemia, living in zip codes with very low or low COI, and who identified as Black/African American non-Hispanic/Latino experienced more MCOs. Our study supports the need to address intersecting sociodemographic, neighborhood, and health system factors that will improve equitable access to necessary healthcare imaging for children.

Indexed as

Fluorodeoxyglucose F18Healthcare DisparitiesLeukemiaLymphomaPositron Emission Tomography Computed TomographyRadiopharmaceuticalsAdolescentChildFemaleHumansMaleRetrospective StudiesSociodemographic FactorsSocioeconomic FactorsFluorodeoxyglucose F18RadiopharmaceuticalsChild Opportunity Index (COI)ChildrenFluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT)Health equityLymphomaMissed care opportunities (MCOs)

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