Evidence map›Paper›PMID 34229901›Full record

ArticleSurgery2022

Racial disparities in the utilization of parathyroidectomy among patients with primary hyperparathyroidism: Evidence from a nationwide analysis of Medicare claims.

Wilson M Alobuia, Tong Meng, Robin M Cisco, Dana T Lin, Insoo Suh, Manjula Kurella Tamura, Amber W Trickey, Electron Kebebew, Carolyn D Seib

Open access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.1field-weighted citation impact, top 12% of its field
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

6 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
  2. Article
  3. Sex-Stratified Predictors of Prolonged Operative Time and Hospital Admission in Outpatient Parathyroidectomy.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024
    Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Wilson M AlobuiaDepartment of Surgery, Stanford University School of Medicine, Palo Alto, CA. Electronic address: https://twitter.com/AChanceToCut.
Tong MengStanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, CA; Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA.
Robin M CiscoDepartment of Surgery, Stanford University School of Medicine, Palo Alto, CA. Electronic address: https://twitter.com/RobinCiscoMD.
Dana T LinDepartment of Surgery, Stanford University School of Medicine, Palo Alto, CA. Electronic address: https://twitter.com/danalinmd.
Insoo SuhDivision of Endocrine Surgery, NYU Langone Health, New York, NY. Electronic address: https://twitter.com/insoosuh.
Manjula Kurella TamuraGeriatric Research, Education and Clinical Center, Veterans Affairs Palo Alto, Palo Alto, CA; Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA.
Amber W TrickeyStanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, CA.
Electron KebebewDepartment of Surgery, Stanford University School of Medicine, Palo Alto, CA.
Carolyn D SeibDepartment of Surgery, Stanford University School of Medicine, Palo Alto, CA; Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, CA; Division of General Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, CA. Electronic address: cseib@stanford.edu.
Twitter (United States) · USPalo Alto University · USPalo Alto Veterans Institute for Research · USStanford Medicine · USStanford University · USVA Palo Alto Health Care System · US

Funding

A Mentoring Program in Kidney Care for Older AdultsK24AG073615 · NIA · STANFORD UNIVERSITY · PI MANJULA KURELLA TAMURA · 2022 to 2026
$651k
The Impact of Treatment Choice on Long-term Outcomes in Older Adults with Primary HyperparathyroidismR03AG060097 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SEIB, CAROLYN DACEY · 2018 to 2019
$237k
NIA NIH HHS K24 AG073615NIA NIH HHS R03 AG060097
6 · The paper itself

Abstract

backgroundAmong patients with primary hyperparathyroidism, parathyroidectomy offers a chance of cure and mitigation of disease-related complications. The impact of race/ethnicity on referral and utilization of parathyroidectomy has not been fully explored.

methodsPopulation-based, retrospective cohort study using 100% Medicare claims from beneficiaries with primary hyperparathyroidism from 2006 to 2016. Associations of race/ethnicity with disease severity, surgeon evaluation, and subsequent parathyroidectomy were analyzed using adjusted multivariable logistic regression models.

resultsAmong 210,206 beneficiaries with primary hyperparathyroidism, 63,136 (30.0%) underwent parathyroidectomy within 1 year of diagnosis. Black patients were more likely than other races/ethnicities to have stage 3 chronic kidney disease (10.8%) but had lower prevalence of osteoporosis and nephrolithiasis compared to White patients, Black and Hispanic patients were more likely to have been hospitalized for primary hyperparathyroidism-associated conditions (White 4.8%, Black 8.1%, Hispanic 5.8%; P < .001). Patients who were White and met operative criteria were more likely to undergo parathyroidectomy than Black, Hispanic, or Asian patients (White 30.5%, Black 23.0%, Hispanic 21.4%, Asian 18.7%; P < .001). Black and Hispanic patients had lower adjusted odds of being evaluated by a surgeon (odds ratios 0.71 [95% confidence interval 0.69-0.74], 0.68 [95% confidence interval 0.61-0.74], respectively) and undergoing parathyroidectomy if evaluated by a surgeon (odds ratios 0.72 [95% confidence interval 0.68-0.77], 0.82 [95% confidence interval 0.67-0.99]). Asian race was associated with lower adjusted odds of being evaluated by a surgeon (odds ratio 0.64 [95% confidence interval 0.57-0.71]), but no difference in odds of parathyroidectomy.

conclusionRacial/ethnic disparities exist in the management of primary hyperparathyroidism among older adults. Determining the factors that account for this disparity require urgent attention to achieve parity in the management of primary hyperparathyroidism.

Indexed as

Administrative Claims, HealthcareAgedAged, 80 and overBlack or African AmericanFemaleHealthcare DisparitiesHispanic or LatinoHumansHyperparathyroidism, PrimaryMaleMedicareParathyroidectomyPatient Acceptance of Health CareRetrospective StudiesUnited StatesWhite People

Identifiers

PMID34229901
PMCPMC8688157
OpenAlexW3181397442

What OpenQuestion holds

Textmetadata
LicenceTDM
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.