Evidence map›Paper›PMID 28053009›Full record

ArticleNeurology2017

Progressive rural-urban disparity in acute stroke care.

Sergio Gonzales, Michael T Mullen, Lesli Skolarus, Dylan P Thibault, Uduak Udoeyo, Allison W Willis

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Gaps in artificial intelligence research for rural health in the United States: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2026
    Article
  5. Observational
  6. Article
  7. Article
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  9. Article
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  11. Article
  12. Article
  13. Observational
  14. Article
  15. Article
  16. Racial and ethnic disparities in the usage and outcomes of ischemic stroke treatment in the United States.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023
    Observational
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Sergio GonzalesFrom the Leonard Davis Institute of Health Economics (S.G., M.T.M., A.W.W.), Center for Clinical Epidemiology and Biostatistics (D.P.T., A.W.W.), and Department of Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania; Department of Neurology (S.G., M.T.M., D.P.T., A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (L.S., A.W.W.), University of Michigan, Ann Arbor; and Dorsnsife School of Public Health (U.U.), Drexel University, Philadelphia, PA.
Michael T MullenFrom the Leonard Davis Institute of Health Economics (S.G., M.T.M., A.W.W.), Center for Clinical Epidemiology and Biostatistics (D.P.T., A.W.W.), and Department of Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania; Department of Neurology (S.G., M.T.M., D.P.T., A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (L.S., A.W.W.), University of Michigan, Ann Arbor; and Dorsnsife School of Public Health (U.U.), Drexel University, Philadelphia, PA.
Lesli SkolarusFrom the Leonard Davis Institute of Health Economics (S.G., M.T.M., A.W.W.), Center for Clinical Epidemiology and Biostatistics (D.P.T., A.W.W.), and Department of Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania; Department of Neurology (S.G., M.T.M., D.P.T., A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (L.S., A.W.W.), University of Michigan, Ann Arbor; and Dorsnsife School of Public Health (U.U.), Drexel University, Philadelphia, PA.
Dylan P ThibaultFrom the Leonard Davis Institute of Health Economics (S.G., M.T.M., A.W.W.), Center for Clinical Epidemiology and Biostatistics (D.P.T., A.W.W.), and Department of Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania; Department of Neurology (S.G., M.T.M., D.P.T., A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (L.S., A.W.W.), University of Michigan, Ann Arbor; and Dorsnsife School of Public Health (U.U.), Drexel University, Philadelphia, PA.
Uduak UdoeyoFrom the Leonard Davis Institute of Health Economics (S.G., M.T.M., A.W.W.), Center for Clinical Epidemiology and Biostatistics (D.P.T., A.W.W.), and Department of Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania; Department of Neurology (S.G., M.T.M., D.P.T., A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (L.S., A.W.W.), University of Michigan, Ann Arbor; and Dorsnsife School of Public Health (U.U.), Drexel University, Philadelphia, PA.
Allison W WillisFrom the Leonard Davis Institute of Health Economics (S.G., M.T.M., A.W.W.), Center for Clinical Epidemiology and Biostatistics (D.P.T., A.W.W.), and Department of Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania; Department of Neurology (S.G., M.T.M., D.P.T., A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (L.S., A.W.W.), University of Michigan, Ann Arbor; and Dorsnsife School of Public Health (U.U.), Drexel University, Philadelphia, PA. allison.willis@uphs.upenn.edu.

Funding

A Community Partnership to Treat StrokeK23NS073685 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SKOLARUS, LESLI ELIZABETH · 2011 to 2016
$924k
NINDS NIH HHS K23 NS073685
6 · The paper itself

Abstract

objectiveTo explore rural-urban differences and trends in tissue plasminogen activator (tPA) utilization among acute ischemic stroke (AIS) patients and examine the association between primary stroke center (PSC) growth and geographic disparity in tPA use.

methodsWe used hospital discharge data from the National Inpatient Sample (NIS) from 2000 to 2010 and indicators of tPA utilization and describe temporal trends in geographic disparities in AIS care during PSC growth. The Gini coefficient was used to quantify rural-urban inequity in tPA use at the state level (from 0% to 100% of maximum potential rural-urban inequity) in tPA use.

resultsOf 914,500 cases of AIS between 2001 and 2010, 2.3% (n = 21, 190) received tPA. The rural-urban disparity in tPA worsened: tPA use in urban hospitals quadrupled (1.17%-4.87%) compared to rural hospitals (0.87%-1.59%). Of 33 states with NIS data, 15 reached at least 75% of the maximum rural-urban inequality from 2004 to 2010.

conclusionsGeographic disparities in tPA use for AIS are increasing. Greater understanding of the effectors of tPA utilization is necessary to ensure that access to tPA treatment is equitable for all communities in the United States.

Indexed as

Thrombolytic TherapyAgedAged, 80 and overBrain IschemiaCross-Sectional StudiesFemaleFibrinolytic AgentsHealthcare DisparitiesHospitalizationHumansMaleMiddle AgedRural PopulationStrokeTissue Plasminogen ActivatorUnited StatesFibrinolytic AgentsTissue Plasminogen Activator

Identifiers

PMID28053009
PMCPMC5278944

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.