Examining the Spatial Varying Effects of Sociodemographic Factors on Adult Cochlear Implantation Using Geographically Weighted Poisson Regression.

Autor:	Lee MS; Faculty of Medicine, University of British Columbia, Vancouver., Lin VY, Mei Z; Manifold Data Mining Inc., Mei J; Manifold Data Mining Inc., Chan E; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada., Shipp D; Sunnybrook Cochlear Implant Program, Sunnybrook Health Sciences Centre., Chen JM, Le TN
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2023 Jun 01; Vol. 44 (5), pp. e287-e294. Date of Electronic Publication: 2023 Mar 24.
DOI:	10.1097/MAO.0000000000003861
Abstrakt:	Objective: To (i) demonstrate the utility of geographically weighted Poisson regression (GWPR) in describing geographical patterns of adult cochlear implant (CI) incidence in relation to sociodemographic factors in a publicly funded healthcare system, and (ii) compare Poisson regression and GWPR to fit the aforementioned relationship. Study Design: Retrospective study of provincial CI Program database. Setting: Academic hospital. Patients: Adults 18 years or older who received a CI from 2020 to 2021. Interventions: Cochlear implant. Main Outcome Measures: CI incidence based on income level, education attainment, age at implantation, and distance from center, and spatial autocorrelation across census metropolitan areas. Results: Adult CI incidence varied spatially across Ontario (Moran's I = 0.04, p < 0.05). Poisson regression demonstrated positive associations between implantation and lower income level (coefficient = 0.0284, p < 0.05) and younger age (coefficient = 0.1075, p < 0.01), and a negative association with distance to CI center (coefficient = -0.0060, p < 0.01). Spatial autocorrelation was significant in Poisson model (Moran's I = 0.13, p < 0.05). GWPR accounted for spatial differences (Moran's I = 0.24, p < 0.690), and similar associations to Poisson were observed. GWPR further identified clusters of implantation in South Central census metropolitan areas with higher education attainment. Conclusions: Adult CI incidence demonstrated a nonstationary relationship between implantation and the studied sociodemographic factors. GWPR performed better than Poisson regression in accounting for these local spatial variations. These results support the development of targeted interventions to improve access and utilization to CIs in a publicly funded healthcare system. Competing Interests: Sources of support and disclosure of funding: The work was not supported by any funding source. Authors V.Y.L. and J.M.C. have served on surgical advisory boards for Cochlear, Advanced Bionics, and Med-El in the past without financial or other compensation. The remaining authors have no conflicts of interest to declare. (Copyright © 2023, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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