Research Award Details

2021 - POSNA Microgrant

Prevalence of Marijuana use and Associated Complications in Adolescent Idiopathic Scoliosis: A Pilot Study


Grant Recipient: Grant Hogue, MD

Institution:
Boston Children's Hospital - Harvard Medical School
Presentations & Publications:
Presentations: Forthcoming. Will be submitted to next POSNA meeting. Publications: Forthcoming
Additional Information:
Name of Principal Investigator: Grant Hogue MD
Study title: Prevalence of Marijuana Use and Associated Complications in Adolescent Idiopathic Scoliosis: A Pilot Study
Name of award: POSNA Fall Micro Grant
Year in which the grant/award was funded: Fall 2021
A. Study Aims:
Primary Aim: To determine self-reported MJ prevalence among AIS patients operated on during 2011-2017 and if there was an increase in yearly MJ use reporting.
Primary Hypothesis:
We predict 7% of AIS patients within the cohort to report using MJ [2], and that MJ use prevalence will be higher in 2012-2017 than in 2011.
Primary Outcome:
Positive attestation to MJ use during AIS patient intake process.

Secondary Aims, Hypotheses, Outcomes:
Aim 2: To determine whether there are differences in surgical AIS outcomes between patients who report using MJ versus those who report as non-MJ users.
Hypothesis: MJ users will experience worse intraoperative, perioperative, and postoperative outcomes compared to non-MJ users.
Outcomes:
• Intraoperative: surgical time and estimated blood loss per level fused (EBL)
• Perioperative: length-of-stay (LOS), transient events, pain control, narcotic use, vital signs, initial curve correction.
• Postoperative: 90-day readmission rate, complication rate, curve correction, curve progression.

Aim 3: To determine if child opportunity index (COI) is associated with the reported use of MJ in AIS patients. Hypothesis: AIS patients with a lower COI will be associated with reporting MJ use compared to AIS patients with a higher COI.
Outcome: Positive attestation to MJ use during AIS patient intake process.

Research findings: Project is ongoing. Initially, it the rate of positive attestation to use of marijuana was much lower than the national average and we believed this to be spurious. After developing an NLP algorithm, we have been able to identify a greater number of patients in our cohort who have positive attestations for marijuana use. We are currently compiling perioperative and postoperative data on this cohort to be compared to cohort without exposure/use of marijuana.

Expenditures: expenditure report attached.

Further grant obtained as result of POSNA funding: This pilot study revealed that there is great difficulty in determination of marijuana use in a retrospective fashion. We have been able to find more patients with positive attestation (even if they did not have a positive attestation at their spine clinic appointments), but creating a natural language processing algorithm and applying it to the entire patient medical record. In building this protocol we also have built a similar protocol for our patient cohort undering ACL reconstruction, and our cohort undergoing periacetabular osteotomy. When these three pilot studies have final findings we will use this to apply for long-term funding for a prospective endeavor.