Evidence map›Paper›PMID 34479055›Full record

ArticleParkinsonism & related disorders2021

Racial and geographic disparities with gastrostomy tube placement in dementia and parkinsonian disorders.

Duk Soo Kim, Zachary J Kunicki, Oliver W Philips, Richard N Jones, Joseph H Friedman, Benzi Kluger, Umer Akbar

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

Article in Parkinsonism & related disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
0.4field-weighted citation impact, top 43% 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, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Mapping racial and ethnic healthcare disparities for persons living with dementia: A scoping review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
    Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Duk Soo KimDepartment of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA.
Zachary J KunickiDepartment of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Oliver W PhilipsDepartment of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA.
Richard N JonesDepartment of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Joseph H FriedmanDepartment of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA.
Benzi KlugerDepartment of Neurology, University of Rochester, Rochester, NY, USA.
Umer AkbarDepartment of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA; Butler Hospital, Providence, RI, USA. Electronic address: umer_akbar@brown.edu.
Providence College · USBrown University · USUniversity of Rochester · US

Funding

Advancing Palliative Care for Older Adults Affected by Neurodegenerative Disease: Parkinsons disease, Alzheimers disease and Related DementiasK02AG062745 · NIA · UNIVERSITY OF ROCHESTER · PI KLUGER, BENZI M · 2020 to 2024
$711k
NIA NIH HHS K02 AG062745
6 · The paper itself

Abstract

introductionMany patients with advanced dementia and Parkinson's disease and related disorders (PDRD) are receiving gastrostomy tube (GT) placement annually, despite its lack of proven benefit for preventing aspiration, enhancing nutrition, or prolonging survival. Given clinical practice variability in the care of people with neurodegenerative disorders, we sought to examine racial and geographic disparities in GT placement for these populations in the United States.

methodData were extracted from a publicly-available national database using diagnostic and procedural codes from 2006 to 2010. GT placement rates and odds ratios were calculated for two groups: PDRD and non-parkinsonian dementia (NPD).

resultsIn the PDRD group, odds of GT placement were higher among patients coded as Black (OR 1.69, CI 0.80-3.56, p = 0.17) and Asian (OR 2.17, CI 0.70-6.78, p = 0.18) than Whites; although these tendencies did not reach statistical significance. In the NPD group, GT placement among Black patients was significantly more likely (OR 2.88, CI 1.90-4.36, p < 0.001) than their white counterparts, while Asian patients were significantly less likely (OR 0.12, CI 0.02-0.91, p = 0.04). Compared to the Northeast region, there were significantly lower odds of GT placement in the Midwest region (OR 0.37, CI 0.24-0.58, p < 0.001) in the NPD group only. No difference in odds was observed between the sexes in both groups.

conclusionThis study showed geographic and racial disparities in GT placement among PDRD and NPD patients. Further studies should aim to clarify best practices for GT placement in PDRD and causes of practice differences within and between PDRD and NPD groups.

Indexed as

AgedAged, 80 and overDatabases, FactualDementiaEnteral NutritionFemaleGastrostomyGeographyHealthcare DisparitiesHumansMaleOdds RatioParkinsonian DisordersRacial GroupsUnited StatesAlzheimer's diseaseGastrostomy tubeGeographic disparityNeurodegenerative diseasesParkinson's diseaseRacial disparity

Identifiers

PMID34479055
PMCPMC9486970
OpenAlexW3197731752

What OpenQuestion holds

Textmetadata
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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.