Christina Zhu, Wynne Zheng, Emily Clementi, Maeen Arslan, Christopher Guirguis, Daniel Spielman
{"title":"Evaluation of Disparities in Management of Chronic Rhinosinusitis by Race and Ethnicity: An All of Us Research Program Study.","authors":"Christina Zhu, Wynne Zheng, Emily Clementi, Maeen Arslan, Christopher Guirguis, Daniel Spielman","doi":"10.1177/19458924251383016","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveTo evaluate disparities in the management of chronic rhinosinusitis (CRS) across racial, ethnic, and gender groups, focusing on treatment patterns and associated comorbidities.MethodsThis cross-sectional study analyzed data from 28,278 adults with CRS in the NIH All of Us Research Program between 2018 and 2022. Multivariable logistic regression was used to assess associations between demographic variables, associated comorbidities, and receipt of treatments including systemic steroids, leukotriene modifiers, antibiotics, biologics, and sinus surgery.ResultsBlack individuals had higher odds of receiving systemic steroids (OR: 1.59, <i>P</i> < .0001) and antibiotics (OR: 1.67, <i>P</i> < .0001), but were less likely to receive biologics (OR: 0.30, <i>P</i> = .051). Non-Hispanic individuals were more likely to receive systemic steroids (OR: 1.54, <i>P</i> < .001) and antibiotics (OR: 1.54, <i>P</i> = .0007), but were less likely to undergo sinus surgery (OR: 0.67, <i>P</i> = .016). Male sex was associated with reduced odds of receiving systemic steroids (OR: 0.86, <i>P</i> < .0001), leukotriene modifiers (OR: 0.81, <i>P</i> < .001), and antibiotics (OR: 0.91, <i>P</i> < .001) but increased odds of undergoing surgery (OR: 1.37, <i>P</i> < .0001). Presence of nasal polyps and comorbid asthma strongly predicted use of biologics (ORs: 4.39 and 13.83, respectively, <i>P</i> < .0001) and surgical intervention (ORs: 13.13 and 1.34, respectively, <i>P</i> < .0001).ConclusionSignificant racial, ethnic, and gender disparities exist in the treatment of CRS, independent of comorbidities. These findings highlight the need for equity-focused strategies to ensure timely access to advanced therapies and to address structural barriers that may influence treatment allocation.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251383016"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Rhinology & Allergy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19458924251383016","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
ObjectiveTo evaluate disparities in the management of chronic rhinosinusitis (CRS) across racial, ethnic, and gender groups, focusing on treatment patterns and associated comorbidities.MethodsThis cross-sectional study analyzed data from 28,278 adults with CRS in the NIH All of Us Research Program between 2018 and 2022. Multivariable logistic regression was used to assess associations between demographic variables, associated comorbidities, and receipt of treatments including systemic steroids, leukotriene modifiers, antibiotics, biologics, and sinus surgery.ResultsBlack individuals had higher odds of receiving systemic steroids (OR: 1.59, P < .0001) and antibiotics (OR: 1.67, P < .0001), but were less likely to receive biologics (OR: 0.30, P = .051). Non-Hispanic individuals were more likely to receive systemic steroids (OR: 1.54, P < .001) and antibiotics (OR: 1.54, P = .0007), but were less likely to undergo sinus surgery (OR: 0.67, P = .016). Male sex was associated with reduced odds of receiving systemic steroids (OR: 0.86, P < .0001), leukotriene modifiers (OR: 0.81, P < .001), and antibiotics (OR: 0.91, P < .001) but increased odds of undergoing surgery (OR: 1.37, P < .0001). Presence of nasal polyps and comorbid asthma strongly predicted use of biologics (ORs: 4.39 and 13.83, respectively, P < .0001) and surgical intervention (ORs: 13.13 and 1.34, respectively, P < .0001).ConclusionSignificant racial, ethnic, and gender disparities exist in the treatment of CRS, independent of comorbidities. These findings highlight the need for equity-focused strategies to ensure timely access to advanced therapies and to address structural barriers that may influence treatment allocation.
目的评价慢性鼻窦炎(CRS)治疗在不同种族、民族和性别群体中的差异,重点关注治疗模式和相关合并症。这项横断面研究分析了2018年至2022年美国国立卫生研究院“我们所有人”研究项目中28278名CRS成年人的数据。采用多变量logistic回归来评估人口统计学变量、相关合并症和接受治疗(包括全身类固醇、白三烯调节剂、抗生素、生物制剂和鼻窦手术)之间的相关性。结果黑人接受全身性类固醇的几率更高(OR: 1.59, P P = 0.051)。非西班牙裔个体更有可能接受全身性类固醇(OR: 1.54, P =。0007),但接受鼻窦手术的可能性较小(OR: 0.67, P = 0.016)。男性与接受全身性类固醇的几率降低相关(OR: 0.86, P P P P P P
期刊介绍:
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.