Lack of disparities in screening for associated anomalies in children with anorectal malformations

Laura V. Veras, Justin R. Smith, Ankush Gosain

Research output: Contribution to journalArticle

Abstract

Introduction: Patients with anorectal malformations (ARM) often have associated congenital anomalies and should undergo several screening exams in the first year of life. We hypothesized that racial and socioeconomic disparities exist in the screening processes for these patients. Methods: After IRB approval, a retrospective review of patients with ARM born between 2005 and 2016 was performed at a quaternary care children's hospital. Demographics including gender, race, insurance, and zip code were collected. Zip code was used as a surrogate for median income. Chart review was performed to identify anomaly type and whether Vertebral defects, Anorectal malformations, Cardiac defects, Tracheo-Esophageal fistula, Renal anomalies, and Limb abnormalities screening was performed within 1 y of age. Descriptive statistics and chi square analyses were performed. Results: One hundred patients (59% male, 68% low malformation) were identified. African American and Caucasian subjects represented 41% and 40% of the population, respectively. Overall, 68 of 100 patients had at least one screening test for each of the Vertebral defects, Anorectal malformations, Cardiac defects, Tracheo-Esophageal fistula, Renal anomalies, and Limb abnormalities associations. Although some minor differences were noted (more African Americans received skeletal survey than Caucasians, 80.5% versus 60%, P = 0.00335), no pattern of systematic bias in the receipt or timing of screening was evident based on race, insurance, or income. Conclusions: There do not appear to be racial or socioeconomic disparities in screening for associated anomalies in patients with ARM. However, overall gaps in screening still exist, and work must be carried out to appropriately screen all patients for associated anomalies.

Original languageEnglish (US)
Pages (from-to)10-14
Number of pages5
JournalJournal of Surgical Research
Volume231
DOIs
StatePublished - Nov 1 2018

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Esophageal Fistula
Insurance
African Americans
Extremities
Kidney
Research Ethics Committees
Child Care
Anorectal Malformations
Demography
Population
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Surgery

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Lack of disparities in screening for associated anomalies in children with anorectal malformations. / Veras, Laura V.; Smith, Justin R.; Gosain, Ankush.

In: Journal of Surgical Research, Vol. 231, 01.11.2018, p. 10-14.

Research output: Contribution to journalArticle

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abstract = "Introduction: Patients with anorectal malformations (ARM) often have associated congenital anomalies and should undergo several screening exams in the first year of life. We hypothesized that racial and socioeconomic disparities exist in the screening processes for these patients. Methods: After IRB approval, a retrospective review of patients with ARM born between 2005 and 2016 was performed at a quaternary care children's hospital. Demographics including gender, race, insurance, and zip code were collected. Zip code was used as a surrogate for median income. Chart review was performed to identify anomaly type and whether Vertebral defects, Anorectal malformations, Cardiac defects, Tracheo-Esophageal fistula, Renal anomalies, and Limb abnormalities screening was performed within 1 y of age. Descriptive statistics and chi square analyses were performed. Results: One hundred patients (59{\%} male, 68{\%} low malformation) were identified. African American and Caucasian subjects represented 41{\%} and 40{\%} of the population, respectively. Overall, 68 of 100 patients had at least one screening test for each of the Vertebral defects, Anorectal malformations, Cardiac defects, Tracheo-Esophageal fistula, Renal anomalies, and Limb abnormalities associations. Although some minor differences were noted (more African Americans received skeletal survey than Caucasians, 80.5{\%} versus 60{\%}, P = 0.00335), no pattern of systematic bias in the receipt or timing of screening was evident based on race, insurance, or income. Conclusions: There do not appear to be racial or socioeconomic disparities in screening for associated anomalies in patients with ARM. However, overall gaps in screening still exist, and work must be carried out to appropriately screen all patients for associated anomalies.",
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