To 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).
Retrospective 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.
In 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.
Children 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.
目的:确定计划使用氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET/CT)的淋巴瘤/白血病儿童中MCO的患病率以及社会人口统计学因素和儿童机会指数(COI)的影响。
方法:回顾性分析计划进行FDG-PET/CT(2012年至2022年)的淋巴瘤/白血病儿童的MCO。在单变量分析中,病人,邻居,和预约数据在MCO和完成的预约中进行评估.Logistic回归评估患者的独立效应-,邻居-,以及MCO的任命级别因素。双侧P值<0.05被认为具有统计学意义。
结果:在643个FDG-PET/CT预约中(n=293例;中位年龄15岁(IQR11.0-17.0岁);37.9%女性),有20例MCO(3.1%),涉及16例患者.只有8.2%的任命涉及黑人/非洲裔非西班牙裔/拉丁裔患者,然而,它们占MCO总数的四分之一。生活在COI非常低或低的社区中的患者的MCOs明显高于COI非常高的邮政编码(6.9%vs.0.8%;P=0.02)。Logistic回归显示18~21岁患者发生MCO的可能性显著增加[比值比(OR)4.50;95%CI1.53~13.27;P=0.007],黑人/非洲裔非西班牙裔/拉丁美洲人(OR3.20;95%CI1.08-9.49;P=0.04),具有非常低或低COI的邮政编码(OR9.60;95%CI1.24-74.30;P=0.03),未知的保险状况。
结论:儿童淋巴瘤/白血病,生活在非常低或低COI的邮政编码中,被认定为黑人/非洲裔非西班牙裔/拉丁裔的人经历了更多的MCO。我们的研究支持解决交叉社会人口统计学问题的必要性,邻居,和卫生系统因素,这些因素将改善儿童获得必要的医疗保健成像的公平机会。