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Evaluating Distance Bias in Chronic Rhinosinusitis Outcomes
Amarbir S Gill1, Daniel M Beswick2, Jess C Mace3
1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City.
JAMA Otolaryngology-- Head & Neck Surgery
|May 5, 2022
Summary
Distance traveled for rhinologic care did not impact chronic rhinosinusitis outcomes or disease severity. These findings suggest broader applicability of study results across diverse patient populations, regardless of travel distance.
Area of Science:
- Otolaryngology
- Health Services Research
Background:
- Patient travel distance can influence medical outcomes, a factor known as distance bias.
- Distance bias has not been previously investigated in the context of rhinologic studies.
- Understanding this bias is crucial for accurate outcomes research in otolaryngology.
Purpose of the Study:
- To investigate the relationship between the distance patients travel for care and their chronic rhinosinusitis (CRS) severity.
- To evaluate the association between travel distance and treatment outcomes in CRS patients.
- To determine if distance bias affects rhinologic research.
Main Methods:
- A prospective, multi-institutional, cross-sectional study involving 505 patients with CRS.
- Data collection included patient-reported outcomes using the Sinonasal Outcome Test (SNOT-22) and the Medical Outcomes Study Short Form 6-D (SF-6D).
- Travel distances were calculated from patient residence zip codes; comorbidity data were also collected.
Main Results:
- No significant association was found between the distance traveled and baseline or post-treatment SNOT-22 (symptom severity) or SF-6D (health utility) scores.
- Travel distance did not correlate with the comorbidity burden of patients.
- Patients with prior endoscopic sinus surgery were more inclined to travel longer distances for care.
Conclusions:
- Travel distance to academic tertiary care centers for CRS management was not linked to disease severity or treatment outcomes.
- These findings support the generalizability of research findings across different patient cohorts, irrespective of their travel distance.
- The study addresses a gap in understanding distance bias within rhinologic research.
