犹他州农村和城市成年脑胶质瘤患者的生物库和治疗性临床试验代表性评估。

IF 2.4 Q2 CLINICAL NEUROLOGY
Neuro-oncology practice Pub Date : 2023-05-13 eCollection Date: 2023-10-01 DOI:10.1093/nop/npad026
Emma R Earl, Howard Colman, Joe Mendez, Randy L Jensen, Michael Karsy
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引用次数: 0

摘要

背景:健康的社会决定因素(SDOH),特别是与农村、医疗保健可及性和收入相关的社会决定因子,可能在神经胶质瘤患者的预后中发挥尚未确定的作用,了解它们对临床试验的影响很重要。我们检查了参与神经胶质瘤临床试验的患者的SDOH,并评估了农村和城市患者在试验参与和结果方面的差异。方法:我们回顾性地确定了2012年5月至2022年5月在亨斯迈癌症研究所(HCI)参加神经胶质瘤临床试验的患者,以评估临床试验的参与情况。我们使用多变量模型来评估SDOH和地理信息系统地图,以评估犹他州各县的代表性。我们利用HCI和犹他州癌症注册中心最近10年的神经胶质瘤治疗患者数据集,分别分析生存率和发病率。结果:共有570名参与者(68项试验)居住在犹他州,84.4%来自城市县,13.5%来自农村县,2.1%来自边境(人口最少)县。19个县(65.5%)在试验中的代表性不足(注册参与者与符合条件的参与者),1个县(3.5%)的代表性接近1:1,9个县(31.0%)的代表率过高。入学人数较多的县人口密度较大,人均收入最高,而且靠近HCI。在接受HCI治疗的患者中,来自农村/边境县的患者在几乎所有神经胶质瘤类型(包括胶质母细胞瘤)中的生存率与城市患者相当,尽管在临床试验中的代表性不足。结论:通过强调临床试验注册的差异,我们的研究结果可以支持在代表性不足的地区改善招募的努力,这可以帮助提供者为所有患者提供公平的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An evaluation of biobanking and therapeutic clinical trial representation among adult glioma patients from rural and urban Utah.

Background: Social determinants of health (SDOHs)-specifically those related to rurality, health care accessibility, and income-may play as-yet-unidentified roles in prognosis for glioma patients, and their impact on access to clinical trials is important to understand. We examined SDOHs of patients enrolled in glioma clinical trials and evaluate disparities in trial participation and outcomes between rural and urban patients.

Methods: We retrospectively identified patients enrolled in glioma clinical trials at Huntsman Cancer Institute (HCI) from May 2012 to May 2022 to evaluate clinical trial participation. We used multivariable models to evaluate SDOHs and geographic information system mapping to assess representation across Utah's counties. We utilized the most recent 10-year datasets of patients treated for glioma at HCI and from the Utah Cancer Registry to analyze survival and incidence, respectively.

Results: A total of 570 participants (68 trials) resided in Utah, 84.4% from urban counties, 13.5% from rural counties, and 2.1% from frontier (least-populous) counties. Nineteen counties (65.5%) were underrepresented in trials (enrolled participants vs. eligible), 1 (3.5%) was represented in a near-1:1 ratio, and 9 (31.0%) were overrepresented. Counties with greater enrollment had greater population densities, highest per-capita income, and proximity to HCI. Among patients treated at HCI, patients from rural/frontier counties had equivalent survival with urban patients across nearly all glioma types, including glioblastomas, despite underrepresentation in clinical trials.

Conclusions: By highlighting disparities in clinical trial enrollment, our results can support efforts to improve recruitment in underrepresented regions, which can assist providers in delivering equitable care for all patients.

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来源期刊
Neuro-oncology practice
Neuro-oncology practice CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
11.10%
发文量
92
期刊介绍: Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
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