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Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery

Thomas Jovic, John Gibson, Rowena Griffiths, Thomas Dobbs, Ashley Akbari Orcid Logo, Nicholas Wilson-Jones, Rhodri Costello, Peter Evans, Mark Cooper, Steve Key, Ronan Lyons Orcid Logo, Iain Whitaker

Frontiers in Pediatrics, Volume: 9

Swansea University Authors: Thomas Jovic, John Gibson, Rowena Griffiths, Thomas Dobbs, Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo, Iain Whitaker

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Abstract

Introduction: Previous studies of microtia epidemiology globally have demonstrated significant geographical and ethnic variation, cited broadly as affecting 3–5 in 10,000 live births. The aim of this study was to determine the incidence of microtia in a largely homogeneous ethnic population in the U...

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Published in: Frontiers in Pediatrics
ISSN: 2296-2360
Published: Frontiers Media SA 2021
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2022-08-17T10:43:55.5906592</datestamp><bib-version>v2</bib-version><id>56589</id><entry>2021-03-28</entry><title>Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery</title><swanseaauthors><author><sid>7d95ed2bceb18fc0fdfd4048277c6eed</sid><firstname>Thomas</firstname><surname>Jovic</surname><name>Thomas Jovic</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>681cf87df3796a68ef3da257db7a0a3f</sid><firstname>John</firstname><surname>Gibson</surname><name>John Gibson</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>381464f639f98bd388c29326ca7f862c</sid><firstname>Rowena</firstname><surname>Griffiths</surname><name>Rowena Griffiths</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>d18101ae0b4e72051f735ef68f45e1a8</sid><firstname>Thomas</firstname><surname>Dobbs</surname><name>Thomas Dobbs</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><ORCID>0000-0001-5225-000X</ORCID><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>830074c59291938a55b480dcbee4697e</sid><ORCID/><firstname>Iain</firstname><surname>Whitaker</surname><name>Iain Whitaker</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-03-28</date><deptcode>BMS</deptcode><abstract>Introduction: Previous studies of microtia epidemiology globally have demonstrated significant geographical and ethnic variation, cited broadly as affecting 3&#x2013;5 in 10,000 live births. The aim of this study was to determine the incidence of microtia in a largely homogeneous ethnic population in the United Kingdom (Wales) and to identify factors, such as distance and socioeconomic status, which may influence the access to surgical intervention.Materials and Methods: A retrospective cohort study was conducted using data linkage to identify patients born between 2000 and 2018 with a diagnosis of microtia. Microtia incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Sociodemographic attributes were compared using descriptive statistics to determine differences in access to each type of surgical intervention.Results: A total of 101 patients were identified, 64.4% were male and the median age was 12 (8&#x2013;16). The mean annual incidence was 2.13 microtia cases per 10,000 births over the 19-year study period. Both temporal and geographic variation was noted. The majority of patients undergoing surgery opted for autologous reconstruction (72.9%) at a median age of 9 (7&#x2013;10) compared to 7 (5&#x2013;8) for prosthetic reconstruction. Autologous reconstruction had a higher median number of surgeries (2, 1&#x2013;3) than prosthetic (1.5, 1&#x2013;2) and a higher median socioeconomic status of 3 (2&#x2013;4) compared to 2 (1&#x2013;4) for the prosthetic cohort. There were no statistically significant differences in the distance traveled for surgery.Discussion: This study highlights a role for data linkage in epidemiological analyses and provides a revised incidence of microtia in Wales. Although the majority of patients opted for autologous reconstruction, demographic disparities in socioeconomic status warrant further investigation, emphasizing the importance of striving for equity in accessibility to surgical intervention.</abstract><type>Journal Article</type><journal>Frontiers in Pediatrics</journal><volume>9</volume><journalNumber/><paginationStart/><paginationEnd/><publisher>Frontiers Media SA</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2296-2360</issnElectronic><keywords>microtia, epidemiology, reconstructive surgery, congenital, otology</keywords><publishedDay>26</publishedDay><publishedMonth>3</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-03-26</publishedDate><doi>10.3389/fped.2021.630036</doi><url/><notes/><college>COLLEGE NANME</college><department>Biomedical Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>BMS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was supported by Health Data Research UK [NIWA1] which receives its funding from HDR UK Ltd., funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF), and the Wellcome Trust. This work has also been supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government&#x2019;s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyze anonymized data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). TJ is supported by the Action Medical Research/VTCT Foundation Research Training Fellowship, Microtia UK, and the BAPRAS Paton Masser Memorial Award. IW would like to acknowledge funding from EURAPS/AAPS Academic Scholarship and the Royal College of Surgeons England Cutlers&#x2019; Surgical Fellowship in Ear Reconstruction. This work is part of the AFFECT &amp; 3D BIOFACE projects, supported by the Scar Free Foundation Programme of Regenerative Research at the Reconstructive Surgery &amp; Regenerative Medicine Research Centre (ReconRegen) in partnership with Health &amp; Care Research Wales.</funders><projectreference/><lastEdited>2022-08-17T10:43:55.5906592</lastEdited><Created>2021-03-28T12:02:22.9786920</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Thomas</firstname><surname>Jovic</surname><order>1</order></author><author><firstname>John</firstname><surname>Gibson</surname><order>2</order></author><author><firstname>Rowena</firstname><surname>Griffiths</surname><order>3</order></author><author><firstname>Thomas</firstname><surname>Dobbs</surname><order>4</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>5</order></author><author><firstname>Nicholas</firstname><surname>Wilson-Jones</surname><order>6</order></author><author><firstname>Rhodri</firstname><surname>Costello</surname><order>7</order></author><author><firstname>Peter</firstname><surname>Evans</surname><order>8</order></author><author><firstname>Mark</firstname><surname>Cooper</surname><order>9</order></author><author><firstname>Steve</firstname><surname>Key</surname><order>10</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>11</order></author><author><firstname>Iain</firstname><surname>Whitaker</surname><orcid/><order>12</order></author></authors><documents><document><filename>56589__19647__fe868c1e5ba94feca3f068338fa21962.pdf</filename><originalFilename>56589.pdf</originalFilename><uploaded>2021-04-14T12:44:45.1298211</uploaded><type>Output</type><contentLength>952022</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright &#xA9; 2021 Jovic, Gibson, Griffiths, Dobbs, Akbari, Wilson-Jones, Costello, Evans, Cooper, Key, Lyons and Whitaker. 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spelling 2022-08-17T10:43:55.5906592 v2 56589 2021-03-28 Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery 7d95ed2bceb18fc0fdfd4048277c6eed Thomas Jovic Thomas Jovic true false 681cf87df3796a68ef3da257db7a0a3f John Gibson John Gibson true false 381464f639f98bd388c29326ca7f862c Rowena Griffiths Rowena Griffiths true false d18101ae0b4e72051f735ef68f45e1a8 Thomas Dobbs Thomas Dobbs true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 830074c59291938a55b480dcbee4697e Iain Whitaker Iain Whitaker true false 2021-03-28 BMS Introduction: Previous studies of microtia epidemiology globally have demonstrated significant geographical and ethnic variation, cited broadly as affecting 3–5 in 10,000 live births. The aim of this study was to determine the incidence of microtia in a largely homogeneous ethnic population in the United Kingdom (Wales) and to identify factors, such as distance and socioeconomic status, which may influence the access to surgical intervention.Materials and Methods: A retrospective cohort study was conducted using data linkage to identify patients born between 2000 and 2018 with a diagnosis of microtia. Microtia incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Sociodemographic attributes were compared using descriptive statistics to determine differences in access to each type of surgical intervention.Results: A total of 101 patients were identified, 64.4% were male and the median age was 12 (8–16). The mean annual incidence was 2.13 microtia cases per 10,000 births over the 19-year study period. Both temporal and geographic variation was noted. The majority of patients undergoing surgery opted for autologous reconstruction (72.9%) at a median age of 9 (7–10) compared to 7 (5–8) for prosthetic reconstruction. Autologous reconstruction had a higher median number of surgeries (2, 1–3) than prosthetic (1.5, 1–2) and a higher median socioeconomic status of 3 (2–4) compared to 2 (1–4) for the prosthetic cohort. There were no statistically significant differences in the distance traveled for surgery.Discussion: This study highlights a role for data linkage in epidemiological analyses and provides a revised incidence of microtia in Wales. Although the majority of patients opted for autologous reconstruction, demographic disparities in socioeconomic status warrant further investigation, emphasizing the importance of striving for equity in accessibility to surgical intervention. Journal Article Frontiers in Pediatrics 9 Frontiers Media SA 2296-2360 microtia, epidemiology, reconstructive surgery, congenital, otology 26 3 2021 2021-03-26 10.3389/fped.2021.630036 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University This work was supported by Health Data Research UK [NIWA1] which receives its funding from HDR UK Ltd., funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF), and the Wellcome Trust. This work has also been supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyze anonymized data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). TJ is supported by the Action Medical Research/VTCT Foundation Research Training Fellowship, Microtia UK, and the BAPRAS Paton Masser Memorial Award. IW would like to acknowledge funding from EURAPS/AAPS Academic Scholarship and the Royal College of Surgeons England Cutlers’ Surgical Fellowship in Ear Reconstruction. This work is part of the AFFECT & 3D BIOFACE projects, supported by the Scar Free Foundation Programme of Regenerative Research at the Reconstructive Surgery & Regenerative Medicine Research Centre (ReconRegen) in partnership with Health & Care Research Wales. 2022-08-17T10:43:55.5906592 2021-03-28T12:02:22.9786920 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Thomas Jovic 1 John Gibson 2 Rowena Griffiths 3 Thomas Dobbs 4 Ashley Akbari 0000-0003-0814-0801 5 Nicholas Wilson-Jones 6 Rhodri Costello 7 Peter Evans 8 Mark Cooper 9 Steve Key 10 Ronan Lyons 0000-0001-5225-000X 11 Iain Whitaker 12 56589__19647__fe868c1e5ba94feca3f068338fa21962.pdf 56589.pdf 2021-04-14T12:44:45.1298211 Output 952022 application/pdf Version of Record true Copyright © 2021 Jovic, Gibson, Griffiths, Dobbs, Akbari, Wilson-Jones, Costello, Evans, Cooper, Key, Lyons and Whitaker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) true eng http://creativecommons.org/licenses/by/4.0/
title Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
spellingShingle Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
Thomas Jovic
John Gibson
Rowena Griffiths
Thomas Dobbs
Ashley Akbari
Ronan Lyons
Iain Whitaker
title_short Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
title_full Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
title_fullStr Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
title_full_unstemmed Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
title_sort Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
author_id_str_mv 7d95ed2bceb18fc0fdfd4048277c6eed
681cf87df3796a68ef3da257db7a0a3f
381464f639f98bd388c29326ca7f862c
d18101ae0b4e72051f735ef68f45e1a8
aa1b025ec0243f708bb5eb0a93d6fb52
83efcf2a9dfcf8b55586999d3d152ac6
830074c59291938a55b480dcbee4697e
author_id_fullname_str_mv 7d95ed2bceb18fc0fdfd4048277c6eed_***_Thomas Jovic
681cf87df3796a68ef3da257db7a0a3f_***_John Gibson
381464f639f98bd388c29326ca7f862c_***_Rowena Griffiths
d18101ae0b4e72051f735ef68f45e1a8_***_Thomas Dobbs
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
830074c59291938a55b480dcbee4697e_***_Iain Whitaker
author Thomas Jovic
John Gibson
Rowena Griffiths
Thomas Dobbs
Ashley Akbari
Ronan Lyons
Iain Whitaker
author2 Thomas Jovic
John Gibson
Rowena Griffiths
Thomas Dobbs
Ashley Akbari
Nicholas Wilson-Jones
Rhodri Costello
Peter Evans
Mark Cooper
Steve Key
Ronan Lyons
Iain Whitaker
format Journal article
container_title Frontiers in Pediatrics
container_volume 9
publishDate 2021
institution Swansea University
issn 2296-2360
doi_str_mv 10.3389/fped.2021.630036
publisher Frontiers Media SA
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Introduction: Previous studies of microtia epidemiology globally have demonstrated significant geographical and ethnic variation, cited broadly as affecting 3–5 in 10,000 live births. The aim of this study was to determine the incidence of microtia in a largely homogeneous ethnic population in the United Kingdom (Wales) and to identify factors, such as distance and socioeconomic status, which may influence the access to surgical intervention.Materials and Methods: A retrospective cohort study was conducted using data linkage to identify patients born between 2000 and 2018 with a diagnosis of microtia. Microtia incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Sociodemographic attributes were compared using descriptive statistics to determine differences in access to each type of surgical intervention.Results: A total of 101 patients were identified, 64.4% were male and the median age was 12 (8–16). The mean annual incidence was 2.13 microtia cases per 10,000 births over the 19-year study period. Both temporal and geographic variation was noted. The majority of patients undergoing surgery opted for autologous reconstruction (72.9%) at a median age of 9 (7–10) compared to 7 (5–8) for prosthetic reconstruction. Autologous reconstruction had a higher median number of surgeries (2, 1–3) than prosthetic (1.5, 1–2) and a higher median socioeconomic status of 3 (2–4) compared to 2 (1–4) for the prosthetic cohort. There were no statistically significant differences in the distance traveled for surgery.Discussion: This study highlights a role for data linkage in epidemiological analyses and provides a revised incidence of microtia in Wales. Although the majority of patients opted for autologous reconstruction, demographic disparities in socioeconomic status warrant further investigation, emphasizing the importance of striving for equity in accessibility to surgical intervention.
published_date 2021-03-26T04:11:39Z
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