Evidence map›Paper›PMID 39051676›Full record

Observational studyJNCI cancer spectrum2024

Racial and ethnic disparities in robot-assisted radical prostatectomy: testing the physician-level segregated and differential treatment hypotheses.

Jialin Mao, Jeanine M Genkinger, Andrew G Rundle, Jason D Wright, Tabassum Z Insaf, Maria J Schymura, Jim C Hu, Parisa Tehranifar

Abstract readObservational Study
In one paragraph

Observational study in JNCI cancer spectrum, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

8 authors.

Jialin MaoDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.ORCID 0000-0001-6671-3474
Jeanine M GenkingerDepartment of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Andrew G RundleDepartment of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Jason D WrightDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Tabassum Z InsafNew York State Cancer Registry, New York State Department of Health, Albany, NY, USA.
Maria J SchymuraNew York State Cancer Registry, New York State Department of Health, Albany, NY, USA.
Jim C HuDepartment of Urology, Weill Cornell Medicine, New York, NY, USA.
Parisa TehranifarDepartment of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.

Funding

Dean's DiversityHealthcare Disparity Research Awards of Weill Cornell Medicine
6 · The paper itself

Abstract

backgroundMechanisms underlying racial and ethnic disparities in robot-assisted radical prostatectomy (RARP) vs open radical prostatectomy (ORP) are unclear. We sought to test 2 physician-level hypotheses: 1) Segregated Treatment and 2) Differential Treatment.

methodsThis observational study used the New York State Cancer Registry linked to discharge records and included patients undergoing radical prostatectomy for localized prostate cancer from October 1, 2008 to December 31, 2018. For hypothesis 1, we examined the association between patient race and ethnicity and treating surgeon RARP use (high-use surgeons, low-use surgeons, and surgeons at non-RARP facilities). For hypothesis 2, we determined the association between patient race and ethnicity and receipt of RARP when matching on treating surgeon, age, year of procedure, and Gleason group. We explored the role of insurance in both analyses.

resultsThis study included 18 926 patients (8.0% Hispanic, 16.9% non-Hispanic Black, 75.1% non-Hispanic White), with a mean age of 60.4 ± 7.1 years. Compared with non-Hispanic White patients, Hispanic and non-Hispanic Black patients had higher odds of being treated by low-RARP-use surgeons (odds ratio [OR] = 2.16, 95% confidence interval [CI] = 1.20 to 3.88; OR = 1.76, 95% CI = 1.06 to 2.94, respectively) and by surgeons at non-RARP facilities (OR = 4.19, 95% CI = 2.18 to 8.07; OR = 4.60, 95% CI = 2.58 to 8.23, respectively). In the matched cohorts, Hispanic and non-Hispanic Black patients were less likely to receive RARP than non-Hispanic White patients (OR = 0.78, 95% CI = 0.62 to 0.98; OR = 0.75, 95% CI = 0.57 to 1.00, respectively). These associations were partially attenuated after accounting for insurance.

conclusionsRacial and ethnic disparities in RARP use are related to patients being treated by different surgeons and treated differently by the same surgeons. Identifying and addressing multilevel barriers to equitable surgical treatment is needed to reduce disparities among prostate cancer patients.

Indexed as

Healthcare DisparitiesProstatectomyProstatic NeoplasmsRobotic Surgical ProceduresAgedBlack or African AmericanEthnicityHispanic or LatinoHumansInsurance, HealthMaleMiddle AgedNeoplasm GradingNew YorkRacial GroupsRegistries

Identifiers

PMID39051676
PMCPMC11340640

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.