Real World Evidence for Quality of Schwannomatosis Care Within the United States
Christy Soares1, Heather Radtke2, Kaleb Yohay3, Nicole Ullrich4, Scott Plotkin5, Vanessa Merker6, Justin Jordan6
1Neurology, Emory University Hospital, 2Children's Tumor Foundation, 3NYU Langone Medical Center, 4Boston Children'S Hospital, 5Mass General Cancer Center, 6Massachusetts General Hospital
Objective:
We sought to assess whether patients with NF2-related schwannomatosis (NF2-SWN) and non-NF2 related schwannomatosis (non-NF2-SWN) received care in line with published recommendations.
Background:
We previously published data about the variability in clinician awareness of and agreement with recommended care for patients with NF2-SWN and non-NF2-SWN1.
Design/Methods:

An electronic survey was sent to US-based patients and caregivers affected by NF2-SWN and non-NF2-SWN who were enrolled in the CTF's NF Registry. Survey topics included demographics, SWN care location, and self-reported clinical care in accordance with published recommendations.

Results:

Demographic data was available for 746 patients with NF2-SWN and 204 patients with non-NF2-SWN. Among patients with NF2-SWN, 24% of cases were inherited, 48% reported undergoing genetic testing. In contrast, 45% of non-NF2-SWN patients reported undergoing genetic testing. Despite the complexity of these diseases, only 60% of patients with NF2-SWN and 29% of patients with non-NF2-SWN reported receiving care in a specialized NF clinic. Sixty-four percent of patients with NF2-SWN reported receiving an audiogram in the last 12 months, while 84% reported receiving a brain MRI in the last 12 months and 96% reported receiving a spine MRI in the last 36 months.

Conclusions:

The survey revealed that a large proportion of patients living with SWN in the US don't attend a specialized clinic or haven't received recommended genetic testing/counseling. While timely receipt of recommended MRIs of the neuraxis is reported in a high proportion of patients, routine audiograms are performed in about two-thirds of NF2-SWN despite the risk of hearing loss. In the absence of treatment-associated guidelines, there is little current insight into the quality of therapy for these patients. These data serve as a benchmark for organizations that focus on expanding access to expertise for SWN. Development of treatment-associated recommendations would benefit both patients in specialized clinics and elsewhere.

10.1212/WNL.0000000000208413
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