Table 8.
—Factors Associated With TBNA Use Among Pulmonologists
| Univariate Analysis | Multivariate Analysis | ||||
| Variables | % Having TBNA | Crude OR (95% CI) | P Value | Crude OR (95% CI) | P Value |
| Patient age, y | |||||
| 66-70 | 12.0 | Reference | … | Reference | … |
| 71-75 | 10.0 | 0.82 (0.68-0.98) | .0291 | 0.82 (0.69-0.98) | .0265 |
| 76-80 | 10.3 | 0.84 (0.70-1.03) | .0869 | 0.84 (0.70-1.00) | .0458 |
| > 80 | 8.5 | 0.68 (0.53-0.87) | .0022 | 0.69 (0.54-0.87) | .0016 |
| Patient sex | |||||
| Male | 10.7 | Reference | … | … | … |
| Female | 10.3 | 0.96 (0.83-1.11) | .6024 | … | … |
| Patient race | |||||
| White | 10.6 | Reference | … | … | … |
| Hispanic | 9.0 | 0.83 (0.57-1.20) | .3238 | … | … |
| Black | 11.8 | 1.12 (0.86-1.47) | .3969 | … | … |
| Other | 6.6 | 0.60 (0.36-0.99) | .0439 | … | … |
| Urban/rural | |||||
| Big metro | 9.9 | Reference | … | Reference | … |
| Metro | 11.7 | 1.20 (1.02-1.42) | .0292 | 1.75 (1.36-2.26) | < .0001 |
| Urban | 10.0 | 1.01 (0.74-1.36) | .9763 | 1.40 (0.99-1.98) | .0565 |
| Less urban | 10.3 | 1.05 (0.81-1.34) | .7277 | 1.48 (1.09-2.01) | .0128 |
| Rural | 10.1 | 1.02 (0.62-1.67) | .9531 | 1.52 (0.97-2.37) | .0672 |
| Year of diagnosis | |||||
| 1995 | 9.1 | Reference | … | … | … |
| 1996 | 6.2 | 0.66 (0.32-1.35) | .2517 | … | … |
| 1997 | 6.9 | 0.74 (0.37-1.50) | .4082 | … | … |
| 1998 | 7.9 | 0.86 (0.44-1.69) | .664 | … | … |
| 1999 | 7.9 | 0.85 (0.42-1.76) | .6672 | … | … |
| 2000 | 10.2 | 1.14 (0.65-1.97) | .6521 | … | … |
| 2001 | 9.5 | 1.05 (0.62-1.76) | .8703 | … | … |
| 2002 | 9.7 | 1.07 (0.64-1.81) | .795 | … | … |
| 2003 | 9.5 | 1.04 (0.62-1.76) | .8714 | … | … |
| 2004 | 12.3 | 1.40 (0.84-2.32) | .1994 | … | … |
| 2005 | 11.2 | 1.26 (0.75-2.11) | .383 | … | … |
| 2006 | 12.2 | 1.38 (0.83-2.31) | .2173 | … | … |
| 2007 | 13.1 | 1.51 (0.90-2.53) | .1154 | … | … |
| SEER/TCR region | |||||
| California | 7.9 | Reference | … | Reference | … |
| Atlanta and rural Georgia | 6.6 | 0.82 (0.5-1.37) | .4546 | 1.15 (0.65-2.05) | .6308 |
| Connecticut | 7.4 | 0.94 (0.62-1.41) | .757 | 0.74 (0.41-1.33) | .3138 |
| Detroit | 17.8 | 2.54 (1.88-3.43) | < .0001 | 3.51 (2.30-5.37) | < .0001 |
| Hawaii | 6.2 | 0.77 (0.35-1.71) | .5237 | 0.64 (0.25-1.64) | .3495 |
| Iowa | 10.0 | 1.29 (0.93-1.80) | .1278 | 1.52 (0.94-2.46) | .0857 |
| Kentucky | 8.6 | 1.10 (0.75-1.60) | .6314 | 1.14 (0.71-1.82) | .5932 |
| Louisiana | 2.9 | 0.35 (0.20-0.60) | .0001 | 0.31 (0.16-0.61) | .0006 |
| New Jersey | 11.9 | 1.58 (1.18-2.12) | .0021 | 1.52 (1.00-2.30) | .0496 |
| New Mexico | 10.9 | 1.43 (0.72-2.84) | .3114 | 1.16 (0.50-2.66) | .7292 |
| Seattle | 21.4 | 3.18 (2.26-4.49) | < .0001 | 2.45 (1.51-4.00) | .0003 |
| Texas | 11.8 | 1.56 (1.22-2.00) | .0004 | 1.02 (0.70-1.49) | .9137 |
| Utah | 16.1 | 2.24 (1.22-4.12) | .0092 | 1.74 (0.76-3.99) | .1867 |
| % Povertya | |||||
| ≤ 4.76 | 10.6 | Reference | … | … | … |
| 4.77-9.07 | 10.2 | 0.96 (0.77-1.18) | .6705 | … | … |
| 9.08-16.53 | 12.3 | 1.18 (0.97-1.45) | .1012 | … | … |
| > 16.53 | 8.9 | 0.82 (0.66-1.03) | .0827 | … | … |
| Unknown | 9.3 | 0.86 (0.55-1.34) | .5078 | … | … |
| % Non-high schoola | |||||
| ≤ 10.09 | 10.5 | Reference | … | … | … |
| 10.1-17.18 | 11.6 | 1.11 (0.91-1.37) | .3052 | … | … |
| 17.19-27.8 | 11.3 | 1.09 (0.89-1.34) | .4133 | … | … |
| > 27.85 | 8.7 | 0.81 (0.65-1.01) | .0622 | … | … |
| Unknown | 9.3 | 0.87 (0.56-1.36) | .5429 | … | … |
| Comorbidity | |||||
| 0 | 11.2 | Reference | … | … | … |
| 1 | 10.3 | 0.91 (0.77-1.07) | .2501 | … | … |
| 2+ | 9.1 | 0.79 (0.65-0.97) | .0211 | … | … |
| T stages | |||||
| T1 (include T0) | 10.8 | Reference | … | Reference | … |
| T2 | 9.0 | 0.82 (0.67-1.01) | .0638 | 0.91 (0.75-1.12) | .3773 |
| T3 | 9.7 | 0.89 (0.66-1.20) | .4401 | 0.91 (0.67-1.25) | .5681 |
| Unknown | 13.9 | 1.34 (1.07-1.67) | .011 | 1.88 (1.48-2.38) | < .0001 |
| Physician sex | |||||
| Male | 10.2 | Reference | … | … | … |
| Female | 12.4 | 1.24 (0.93-1.65) | .1373 | … | … |
| Unknown | 12.1 | 1.21 (0.90-1.62) | .1997 | … | … |
| Physician graduation year | |||||
| Prior to 1980 | 7.2 | Reference | … | Reference | … |
| 1980-1989 | 11.4 | 1.66 (1.39-1.99) | < .0001 | 1.79 (1.36-2.35) | < .0001 |
| After 1990 | 17.1 | 2.67 (2.18-3.27) | < .0001 | 2.66 (1.98-3.58) | < .0001 |
| Unknown | 12.1 | 1.79 (1.31-2.45) | .0002 | 2.38 (1.03-5.50) | .0432 |
| Trained in the United States | |||||
| Yes | 11.8 | Reference | … | Reference | … |
| No | 6.6 | 0.53 (0.44-0.65) | < .0001 | 0.54 (0.41-0.71) | < .0001 |
| Unknown | 11.9 | 1.01 (0.73-1.40) | .9344 | 0.67 (0.27-1.66) | .3834 |
| Degree | |||||
| MD | 10.2 | Reference | … | … | … |
| DO | 14.7 | 1.52 (1.13-2.03) | .0052 | … | … |
| Unknown | 11.9 | 1.19 (0.87-1.64) | .2815 | … | … |
| Total No. of patients | |||||
| 1 | 12.3 | Reference | … | … | … |
| 2-5 | 9.6 | 0.76 (0.58-1.00) | .0525 | … | … |
| 6-10 | 10.3 | 0.82 (0.62-1.08) | .1566 | … | … |
| > 10 | 11.4 | 0.92 (0.69-1.21) | .5429 | … | … |
Population is all patients with an invasive test done by pulmonologists (n = 7,695). Hierarchical analysis with patients nested within physicians.
% Having TBNA is the percentage of patients that ever had TBNA done prior to initiation of treatment. See Table 1 and 2 legends for expansion of abbreviations.
a
% Poverty and % without a high school education is the percentage of people living in that patient’s census tract living below the poverty level or with that level of education.