Evidence map›Paper›PMID 38159098›Full record

ArticleNeuromodulation : journal of the International Neuromodulation Society2024

Disparities in Access to Deep Brain Stimulation and Responsive Neurostimulation Approaches to Drug-Resistant Epilepsy.

Vishal Venkatraman, Brittany G Futch, Alyssa Bartlett, Lexie Z Yang, Hui-Jie Lee, Ben Shofty, Beth A Parente, Shivanand P Lad, Theresa L Williamson, Shervin Rahimpour

Open access · greenAbstract read
In one paragraph

Article in Neuromodulation : journal of the International Neuromodulation Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 19% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. 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

10 authors at 4 institutions in 1 country.

Vishal VenkatramanDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Brittany G FutchDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Alyssa BartlettDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Lexie Z YangDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
Hui-Jie LeeDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
Ben ShoftyDepartment of Neurosurgery, University of Utah Health, Salt Lake City, UT, USA.
Beth A ParenteDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Shivanand P LadDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Theresa L WilliamsonDepartment of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.
Shervin RahimpourDepartment of Neurosurgery, University of Utah Health, Salt Lake City, UT, USA. Electronic address: Shervin.Rahimpour@hsc.utah.edu.
Duke Medical Center · USDuke University · USUniversity of Utah · USMassachusetts General Hospital · US

Funding

NRSA Training CoreTL1TR002555 · NCATS · DUKE UNIVERSITY · PI EDELMAN, DAVID · 2018 to 2022
$3.7M
NCATS NIH HHS TL1 TR002555NINDS NIH HHS L30 NS129010
6 · The paper itself

Abstract

backgroundEpilepsy affects 1% to 2% of the global population, and those who are resistant to medical treatment may be candidates for neuromodulation. In select populations, brain stimulation approaches including deep brain stimulation (DBS) and responsive neurostimulation (RNS) are used. Although studies have shown that patients from Black, Hispanic, lower income, and rural communities have less access to epilepsy care and have lower rates of epilepsy surgery, disparities in the use of brain stimulation for epilepsy treatment are currently not known. MATERIALS AND

methodsWe queried the US National Inpatient Sample data base from January 1, 2014 to December 31, 2019 for all patients discharged with an International Classification of Diseases (ICD) Ninth Revision or ICD Tenth Revision diagnosis of drug-resistant epilepsy. Among these patients discharged, the rates of brain stimulation treatment, including DBS and RNS, were reported in each subgroup of race, ethnicity, and insurance. To generate national estimates, all analyses were weighted.

resultsA total of 237,895 patients discharged with drug-resistant epilepsy were identified, of whom 4,925 (2.1%) received brain stimulation treatment for drug-resistant epilepsy. Black patients (n = 420, 0.9%, odds ratio [OR] = 0.51, 95% CI [0.40, 0.64]) were less likely to receive brain stimulation treatment than were White patients (n = 3300, 2.4%). There was no significant difference between Asian (n = 105, 2.3%, OR = 0.80, 95% CI [0.53, 1.33]) and Hispanic (n = 655, 2.6%, OR = 0.95, 95% CI [0.77, 1.17]) patients and White patients. No significant difference was observed between female (n = 2515, 2.1%, OR = 1.02, 95% CI [0.89, 1.17]) and male (n = 2410, 2.0%) patients either. Patients with Medicare (n = 1150, 1.2%, OR = 0.69, 95% CI [0.57, 0.84]) or Medicaid (n = 1150, 1.8%, OR = 0.52, 95% CI [0.44, 0.62]) were less likely to receive brain stimulation treatment than were those with private insurance as the primary payer (n = 2370, 3.9%).

conclusionsWe discovered significant disparities in the use of brain stimulation treatments for drug-resistant epilepsy based on race and insurance status. More research will be required to determine the cause of these disparities.

Indexed as

Deep Brain StimulationDrug Resistant EpilepsyHealthcare DisparitiesAdolescentAdultAgedChildFemaleHealth Services AccessibilityHumansMaleMedicaidMedicareMiddle AgedUnited StatesYoung Adultdeep brain stimulationdisparitiesepilepsyhealth care accessresponsive neurostimulation

Identifiers

PMID38159098
PMCPMC11193492
OpenAlexW4390350072

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.