Evidence map›Paper›PMID 35388521›Full record

ArticleAnnals of neurology2022

Inequities in Therapy for Infantile Spasms: A Call to Action.

Fiona M Baumer, John R Mytinger, Kerri Neville, Christina Briscoe Abath, Camilo A Gutierrez, Adam L Numis, Chellamani Harini, Zihuai He, Shaun A Hussain, Anne T Berg and 15 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. 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

25 authors.

Fiona M BaumerDepartment of Neurology, Division of Child Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.ORCID 0000-0002-9162-9458
John R MytingerDepartment of Pediatrics, Division of Pediatric Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Kerri NevilleDepartment of Pediatrics, Division of Pediatric Neurology, University of Michigan (Michigan Medicine), Ann Arbor, MI, USA.
Christina Briscoe AbathDepartment of Child Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Camilo A GutierrezDepartment of Neurology, University of Maryland Medical Center, Baltimore, MD, USA.
Adam L NumisDepartment of Neurology, Division of Epilepsy, University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0002-1594-9812
Chellamani HariniDepartment of Child Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Zihuai HeDepartment of Neurology, Division of Child Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.
Shaun A HussainDepartment of Pediatrics, Division of Pediatric Neurology, University of California, Los Angeles, CA, USA.
Anne T BergAnn & Robert H. Lurie Children's Hospital of Chicago and Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.ORCID 0000-0002-0298-5523
Catherine J ChuDepartment of Neurology, Divisions of Child Neurology and Neurophysiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID 0000-0001-7670-9313
William D GaillardCenter for Neuroscience, Children's National Hospital, Washington, DC, USA.
Tobias LoddenkemperDepartment of Child Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Archana PasupuletiCenter for Neuroscience, Children's National Hospital, Washington, DC, USA.
Debopam SamantaDivision of Child Neurology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Rani K SinghDepartment of Pediatrics, Atrium Health-Levine Children's, Charlotte, NC, USA.
Nilika S SinghalDepartment of Neurology, Division of Epilepsy, University of California San Francisco, San Francisco, CA, USA.
Courtney J WusthoffDepartment of Neurology, Division of Child Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.
Elaine C WirrellDepartment of Neurology, Divisions of Epilepsy and Child and Adolescent Neurology, Mayo Clinic, Rochester, MN, USA.
Elissa YozawitzIsabelle Rapin Division of Child Neurology of the Saul R Korey Department of Neurology and Department of Pediatrics, Montefiore Medical Center, New York, NY, USA.
Kelly G KnuppDepartment of Pediatrics and Neurology, University of Colorado, Aurora, CO, USA.
Renée A ShellhaasDepartment of Pediatrics, Division of Pediatric Neurology, University of Michigan (Michigan Medicine), Ann Arbor, MI, USA.
Zachary M GrinspanDepartment of Pediatrics, New York-Presbyterian Komansky Children's Hospital, Weill Cornell Medicine, New York, NY, USA.
Pediatric Epilepsy Research Consortium
National Infantile Spasms Consortium

Funding

Speaking of Spikes: Connectivity and Language in Benign Epilepsy with Centrotemporal SpikesK23NS116110 · NINDS · STANFORD UNIVERSITY · PI BAUMER, FIONA MITCHELL · 2020 to 2024
$1.1M
Evaluating the Role of Inflammation in Neonatal EpileptogenesisK23NS105918 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI NUMIS, ADAM LAWRENCE · 2019 to 2023
$1.1M
NINDS NIH HHS K23 NS105918NINDS NIH HHS K23 NS116110NINDS NIH HHS K23NS116110
6 · The paper itself

Abstract

objectiveThe aim of this study was to determine whether selection of treatment for children with infantile spasms (IS) varies by race/ethnicity.

methodsThe prospective US National Infantile Spasms Consortium database includes children with IS treated from 2012 to 2018. We examined the relationship between race/ethnicity and receipt of standard IS therapy (prednisolone, adrenocorticotropic hormone, vigabatrin), adjusting for demographic and clinical variables using logistic regression. Our primary outcome was treatment course, which considered therapy prescribed for the first and, when needed, the second IS treatment together.

resultsOf 555 children, 324 (58%) were non-Hispanic white, 55 (10%) non-Hispanic Black, 24 (4%) non-Hispanic Asian, 80 (14%) Hispanic, and 72 (13%) other/unknown. Most (398, 72%) received a standard treatment course. Insurance type, geographic location, history of prematurity, prior seizures, developmental delay or regression, abnormal head circumference, hypsarrhythmia, and IS etiologies were associated with standard therapy. In adjusted models, non-Hispanic Black children had lower odds of receiving a standard treatment course compared with non-Hispanic white children (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.20-0.89; p = 0.02). Adjusted models also showed that children with public (vs. private) insurance had lower odds of receiving standard therapy for treatment 1 (OR, 0.42; CI, 0.21-0.84; p = 0.01).

interpretationNon-Hispanic Black children were more often treated with non-standard IS therapies than non-Hispanic white children. Likewise, children with public (vs. private) insurance were less likely to receive standard therapies. Investigating drivers of inequities, and understanding the impact of racism on treatment decisions, are critical next steps to improve care for patients with IS. ANN NEUROL 2022;92:32-44.

Indexed as

Spasms, InfantileBlack PeopleChildHispanic or LatinoHumansProspective StudiesVigabatrinVigabatrin

Identifiers

PMID35388521
PMCPMC9482145

What OpenQuestion holds

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Registered trials

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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.