Evidence map›Paper›PMID 37876670›Full record

ArticleLancet regional health. Americas2023

Trends and disparities in deep brain stimulation utilization in the United States: a Nationwide Inpatient Sample analysis from 1993 to 2017.

Can Sarica, Christopher R Conner, Kazuaki Yamamoto, Andrew Yang, Jürgen Germann, Melissa M Lannon, Nardin Samuel, Michael Colditz, Brendan Santyr, Clement T Chow and 15 more

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

Article in Lancet regional health. Americas, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
9.7field-weighted citation impact, top 1% 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

39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Complications of deep brain stimulation for drug-resistant epilepsy: an analysis from the MAUDE database.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Advertising to Healthcare Professionals: Insights from Parkinson's Disease in the Movement Disorders Journal.Movement disorders : official journal of the Movement Disorder Society · 2026
    Article
  15. Article
  16. Article
  17. Review
  18. Review
  19. The electric brain: approach to suboptimal DBS parameters.Clinical parkinsonism & related disorders · 2026
    Review
  20. Observational
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 at 7 institutions in 4 countries.

Can SaricaDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Christopher R ConnerDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Kazuaki YamamotoDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Andrew YangDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Jürgen GermannDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Melissa M LannonFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Nardin SamuelDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Michael ColditzDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Brendan SantyrDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Clement T ChowDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Christian Iorio-MorinDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
David H Aguirre-PadillaDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Stefan Thomas LangDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Artur VetkasDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Cletus CheyuoDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Aaron LohDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Ghazaleh DarmaniKrembil Research Institute, University Health Network, Toronto, ON, Canada.
Oliver FloutyDepartment of Neurosurgery, University of South Florida, Tampa, FL, United States.
Vanessa MilanoDepartment of Neurosurgery, Rutgers New Jersey Medical School, Newark, NJ, United States.
Michelle PaffDepartment of Neurosurgery, University of California Irvine, Orange, CA, United States.
Mojgan HodaieDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Suneil K KaliaDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Renato P MunhozKrembil Research Institute, University Health Network, Toronto, ON, Canada.
Alfonso FasanoKrembil Research Institute, University Health Network, Toronto, ON, Canada.
Andres M LozanoDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
University of Toronto · CAUniversity Health Network · CAMcMaster University · CARutgers, The State University of New Jersey · USUniversité de Sherbrooke · CAUniversity of California, Irvine · USUniversity of South Florida · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Deep brain stimulation (DBS) is an approved treatment option for Parkinson's Disease (PD), essential tremor (ET), dystonia, obsessive-compulsive disorder and epilepsy in the United States. There are disparities in access to DBS, and clear understanding of the contextual factors driving them is important. Previous studies aimed at understanding these factors have been limited by single indications or small cohort sizes. The aim of this study is to provide an updated and comprehensive analysis of DBS utilization for multiple indications to better understand the factors driving disparities in access. Methods: The United States based National Inpatient Sample (NIS) database was utilized to analyze the surgical volume and trends of procedures based on indication, using relevant ICD codes. Predictors of DBS use were analyzed using a logistic regression model. DBS-implanted patients in each indication were compared based on the patient-, hospital-, and outcome-related variables. Findings: Our analysis of 104,356 DBS discharges from 1993 to 2017 revealed that the most frequent indications for DBS were PD (67%), ET (24%), and dystonia (4%). Although the number of DBS procedures has consistently increased over the years, radiofrequency ablation utilization has significantly decreased to only a few patients per year since 2003. Negative predictors for DBS utilization in PD and ET cohorts included age increase and female sex, while African American status was a negative predictor across all cohorts. Significant differences in patient-, hospital-, and outcome-related variables between DBS indications were also determined. Interpretation: Demographic and socioeconomic-based disparities in DBS use are evident. Although racial disparities are present across all indications, other disparities such as age, sex, wealth, and insurance status are only relevant in certain indications. Funding: This work was supported by Alan & Susan Hudson Cornerstone Chair in Neurosurgery at University Health Network.

Indexed as

Deep brain stimulationDisparitiesNational Inpatient SampleSurgical volumeTrends

Identifiers

PMID37876670
PMCPMC10593574
OpenAlexW4386885189

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.