Objective To provide an updated comparison of apnea‐hypopnea index (AHI), oxygen desaturation index (ODI), respiratory disturbance index (RDI), oxygen saturation (O2 sat), and lowest oxyhemoglobin saturation (LSAT) measured by portable sleep study devices (PSSDs) compared to polysomnography (PSG). Data Sources Primary studies were identified through PubMed, Scopus, CINAHL, and Cochrane. Review Methods A systematic review was performed by searching databases from inception through August 2021. Only studies examining simultaneous monitoring of a PSSD and PSG were included.  Respiratory indices AHI, ODI, RDI, O2 sat, and LSAT was collected Meta‐correlations and meta‐regressions were conducted to compare sleep variable measurements between PSSD and PSG. Results A total of 24 studies (N = 1644 patients) were included. The mean age was 49.5 ± 12.0 (range = 13‐92), mean body mass index (BMI) was 30.4 ± 5.7 (range = 17‐87), and 69.4% were male. Meta‐correlation showed significant associations between PSSD and PSG for AHI (n = 655, r = .888; p < .001), ODI (n = 241, r = .942; p < .001), RDI (n = 313, r = .832; p < .001), O2 sat (n = 171, r = .858; p < .001), and LSAT (n = 197, r = .930; p < .001). Meta‐regressions indicated significant predictive correlations for AHI (n = 655; r = .96; p < .001), ODI (n = 740; r = .75; p = .031), RDI (n = 197; r = .99; p = .005), and LSAT (n = 197; r = .85; p = .030), but not for O2 sat (n = 171; r = .31; p = .692). Conclusions Respiratory indices correlate strongly between PSSD and PSG, which is further supported by meta‐regressions results. PSSD might be a valuable cost and time‐saving OSA screening tool.

The objective of our paper was to answer the following question: how do patients with HPV-related oropharyngeal squamous cell carcinoma OPSCC (Population) enrolled in clinical trials (Intervention), compared with national database reports of HPV-associated OPSCC patients (Comparison), present demographically (Outcome)? We conducted a systematic review and meta-analysis of studies pertaining to clinical trials of HPV-associated OPSCC and participant demographics in the United States. PubMed, Scopus, CINAHL, and the Cochrane Library were searched from inception to 2 February 2022. Studies of overlapping participant cohorts and/or studies conducted outside of the United States were excluded. Primary outcomes were patient age, sex, and race. Secondary outcomes were smoking history, alcohol history, history of prior cancer, and tumor origin site. Meta-analysis of single means (mean, N for each study, and standard deviation) for age, pack years, and smoking years was performed. Pooled prevalence rates of gender, race, alcohol history, tobacco history, and tumor origin site were expressed as a percentage, with 95% confidence intervals. Meta-analysis found patients to be predominately non-smoking white males, with tumors originating from the tonsil. Our findings reflected the demographics reported by the National Cancer Database (NCDB) for HPV-associated OPSCC. This indicates that HPV-associated OPSCC patients are appropriately represented in clinical trial demographics.

6523 Background: For patients with head and neck squamous cell carcinoma (HNSCC), initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery is recommended by NCCN Guidelines and is the only Commission on Cancer Quality Metric for HNSCC due to the robust association of PORT delays with mortality and recurrence. Prior studies have identified that racial and ethnic minority and underinsured patients are at increased risk for PORT delay. However, no studies have examined the role of social vulnerability (i.e., social determinants of health such as education, housing, and transportation) in explaining disparities in PORT delay. To address this gap, this study seeks to evaluate the association of social vulnerability with delays in starting guideline-adherent PORT for patients with HNSCC. Methods: This is a multicenter retrospective cohort study of adult patients with HNSCC undergoing surgery at 3 urban academic centers followed by adjuvant therapy from 2018-2020. The primary outcome was delay in initiating guideline-adherent PORT (i.e., > 6 weeks [42 days] postoperatively). Time-to-PORT (TTP) was analyzed as a secondary outcome. Census-tract level Social Vulnerability Index (SVI) scores were calculated as a national percentile rank (0 to 1) with higher scores indicating greater social vulnerability. Multivariable logistic regression (MLR) was used to evaluate the association of SVI with PORT delay. Kaplan-Meier curves and a log-rank test were used to evaluate differences in TTP between patients in the highest social vulnerability quartile (SVI > 0.75) vs those in the lowest social vulnerability quartile (SVI ≤ 0.25). Results: The study included 505 patients undergoing surgery and adjuvant therapy. The mean age was 62.1 ± 11.9 years; 71% were male, 14% were Black and the most common tumor subsite was oral cavity (61%). The rate of PORT delay was 52% (95% CI 48-57%). Median TTP was 43 days (IQR 35-55 days). The mean overall SVI score was 0.48 ± 0.27. An increase in SVI of 0.25 was associated with a 33% increase in the odds of PORT delay (OR=1.33, 95% CI=1.08 to 1.63; p=0.0067) on MLR adjusted for facility, age, race, ethnicity, health insurance status, cancer subsite, rurality, and distance to the surgical facility. Patients in the highest SVI quartile had a significant increase in TTP relative to those in the lowest SVI quartile (log-rank p=0.012; median TTP = 47 and 42 days, respectively). Conclusions: In this multi-institution study, over half of patients with HNSCC experience delays in starting PORT. Increased census-tract level social vulnerability is associated with a greater risk of delayed initiation of guideline-adherent PORT. These data can be used to: 1) enhance existing risk prediction models and identify patients at-risk for PORT delay who might benefit from a targeted intervention and 2) improve institutional level risk-adjustment for case mix.