ArticleNeurology2014
Disparities in deep brain stimulation surgery among insured elders with Parkinson disease.
Article in Neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
75 citing papers in PubMed, 8 syntheses or guidelines pooled it, 137 citations in OpenAlex.
- Cross-national disparities in end-of-life outcomes and care strategies for Parkinson's disease: a systematic review and meta-analysis of China and the United States.BMC health services research · 2026Pooled it
- Mechanisms of inequitable access to parkinson's disease care: a critical interpretive synthesis.International journal for equity in health · 2025Pooled it
- Global Economic Evaluation of the Reported Costs of Deep Brain Stimulation.Stereotactic and functional neurosurgery · 2024Pooled it
- Disparities in Access to Deep Brain Stimulation for Parkinson's Disease and Proposed Interventions: A Literature Review.Stereotactic and functional neurosurgery · 2024Pooled it
- A systematic review of health disparities research in deep brain stimulation surgery for Parkinson's disease.Frontiers in human neuroscience · 2023Pooled it
- Sex differences in alpha-synucleinopathies: a systematic review.Frontiers in neurology · 2023Pooled it
- Gender discrepancies and differences in motor and non-motor symptoms, cognition, and psychological outcomes in the treatment of Parkinson's disease with subthalamic deep brain stimulation.Frontiers in neurology · 2023Pooled it
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Home Health Management of Parkinson Disease Deep Brain Stimulation: A Randomized Clinical Trial.JAMA neurology · 2021Trial
- Trial
- Payers, Proof, and Public Trust: Lessons From Deep Brain Stimulation for Scaling Brain-Computer Interfaces.Mayo Clinic proceedings. Digital health · 2026Review
- Feasibility for a Community-Based Parkinson Disease Cohort in Hawaii.Neurology. Clinical practice · 2026Article
- Parkinson's through a cultural lens: Diversity in disease expression and care.Journal of Parkinson's disease · 2026Review
- Ethnic and Gender Disparities in Access to Deep Brain Stimulation Surgery for Parkinson's Disease.Movement disorders clinical practice · 2026Article
- Social Determinants of Health, Nursing Care Quality, and Patient Outcomes in Neurological Disorders: A Systematic Review.Risk management and healthcare policy · 2026Review
- Disparities in the Clinical Provision of Deep Brain Stimulation: A Systematic Scoping Review and Grounded-Theory Qualitative Analysis.Movement disorders clinical practice · 2025Article
- Exploring gendered experiences of Parkinson's disease patients and their carers: implications for decision-making in Deep Brain Stimulation.Internal and emergency medicine · 2025Article
- Exploring deep brain stimulation willingness in Black individuals with Parkinson's disease.Equity neuroscience · 2025Article
- Patient, target, device, and program selection for DBS in Parkinson's disease: advancing toward precision care.NPJ Parkinson's disease · 2025Review
- Sex Differences in Parkinson's Disease: A Narrative Review.Neurology and therapy · 2025Review
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo identify sociodemographic, clinical, and physician/practice factors associated with deep brain stimulation (DBS). DBS is a proven surgical therapy for Parkinson disease (PD), but is recommended only for patients with excellent health, results in significant out-of-pocket costs, and requires substantial physician involvement.
methodsRetrospective cohort study of more than 657,000 Medicare beneficiaries with PD. Multivariable logistic regression models examined the association between demographic, clinical, socioeconomic status (SES), and physician/practice factors, and DBS therapy.
resultsThere were significant disparities in the use of DBS therapy among Medicare beneficiaries with PD. The greatest disparities were associated with race: black (adjusted odds ratio [AOR] 0.20, 95% confidence interval [CI] 0.16-0.25) and Asian (AOR 0.55, 95% CI 0.44-0.70) beneficiaries were considerably less likely to receive DBS than white beneficiaries. Women (AOR 0.79, 95% CI 0.75-0.83) also had lower odds of receiving DBS compared with men. Eighteen percent of procedures were performed on patients with PD who had cognitive impairment/dementia, a reported contraindication to DBS. Beneficiaries treated in minority-serving PD practices were less likely to receive DBS, regardless of individual race (AOR 0.76, 95% CI 0.66-0.87). Even after adjustment for demographic and clinical covariates, high neighborhood SES was associated with 1.4-fold higher odds of receiving DBS (AOR 1.42, 95% CI 1.33-1.53).
conclusionsAmong elderly Medicare beneficiaries with PD, race, sex, and neighborhood SES are strong independent predictors of DBS receipt. Racial disparities are amplified when adjusting for physician/clinic characteristics. Future investigations of the demographic differences in clinical need/usefulness of DBS, ease of DBS attainment, and actual/opportunity DBS costs are needed to inform policies to reduce DBS disparities and improve PD quality of care.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.