Evidence map›Paper›PMID 39078278›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2024

Assessing how frailty and healthcare delays mediate the association between sexual and gender minority status and healthcare utilization in the All of Us Research Program.

Chelsea N Wong, Louisa H Smith, Robert Cavanaugh, Dae H Kim, Carl G Streed, Farzana Kapadia, Brianne Olivieri-Mui

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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.

Chelsea N WongDivision of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02445, United States.ORCID 0000-0003-4315-3923
Louisa H SmithRoux Institute, Northeastern University, Portland, ME 04101, United States.ORCID 0000-0001-9029-4644
Robert CavanaughRoux Institute, Northeastern University, Portland, ME 04101, United States.
Dae H KimDivision of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02445, United States.
Carl G StreedSection of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, United States.
Farzana KapadiaD epartment of Epidemiology, New York University School of Global Public Health, New York, NY 10003, United States.
Brianne Olivieri-MuiDepartment of Medicine, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, United States.

Funding

University of Arizona-Banner Health All of Us Research Program OT2OD026549 · OD · UNIVERSITY OF ARIZONA · PI MORENO, FRANCISCO A, REIMAN, ERIC MICHAEL · 2018 to 2023
$78.9M
California Precision Medicine Research Program ConsortiumOT2OD026552 · OD · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI ANTON-CULVER, HODA A, OHNO-MACHADO, LUCILA · 2018 to 2023
$73.4M
All of Us PennsylvaniaOT2OD026554 · OD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E, VISWESWARAN, SHYAM · 2018 to 2023
$72.1M
New York City Consortium for Precision MedicineOT2OD026556 · OD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BIER, LOUISE E, GHARAVI, ALI G · 2018 to 2023
$67.3M
SouthEast Enrollment Center (SEEC) OT2OD026551 · OD · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI CARRASQUILLO, OLVEEN, COLON, VIVIAN · 2018 to 2023
$62.8M
Southern All of Us NetworkOT2OD026548 · OD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI FOUAD, MONA N., KORF, BRUCE R · 2018 to 2023
$60.5M
Illinois Precision Medicine Consortium OT2OD026557 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI AHSAN, HABIBUL, ARGOS, MARIA · 2018 to 2023
$60.5M
The New England Precision Medicine Consortium of the All of Us Research ProgramOT2OD026553 · OD · MASSACHUSETTS GENERAL HOSPITAL · PI CLARK, CHERYL RENEE, KARLSON, ELIZABETH W · 2018 to 2023
$58.8M
Trans-America Consortium of the Health Care Systems Research Network for the All of Us Research ProgramOT2OD026550 · OD · HENRY FORD HEALTH SYSTEM · PI AHMEDANI, BRIAN KENNETH, JOHNSON, CHRISTINE C · 2018 to 2022
$57.3M
All of Us Wisconsin OT2OD026555 · OD · MARSHFIELD CLINIC RESEARCH FOUNDATION · PI BURNSIDE, ELIZABETH S, EDWARDS, DOROTHY FARRAR · 2018 to 2023
$57.2M
Translational Researchin Aging Trainnig ProgramT32AG023480 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI LIPSITZ, LEWIS · 2004 to 2024
$7.6M
Mid-Career Mentoring Award For Patient-Oriented Research in Frailty and Health OutcomesK24AG073527 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI Dae Hyun Kim · 2022 to 2026
$862k
Federally Qualified Health Centers HHSN 263201600085UNational Institutes of Aging K01AG077972NIA NIH HHS K01 AG077972NIA NIH HHS K24 AG073527NIA NIH HHS T32 AG023480NIH HHS OT2 OD026548NIH HHS OT2 OD026549NIH HHS OT2 OD026550NIH HHS OT2 OD026551NIH HHS OT2 OD026552NIH HHS OT2 OD026553NIH HHS OT2 OD026554NIH HHS OT2 OD026555NIH HHS OT2 OD026556NIH HHS OT2 OD026557Office of the Director: Regional Medical Centers 1 OT2 OD026549
6 · The paper itself

Abstract

objectivesTo understand how frailty and healthcare delays differentially mediate the association between sexual and gender minority older adults (OSGM) status and healthcare utilization. MATERIALS AND

methodsData from the All of Us Research Program participants ≥50 years old were analyzed using marginal structural modelling to assess if frailty or healthcare delays mediated OSGM status and healthcare utilization. OSGM status, healthcare delays, and frailty were assessed using survey data. Electronic health record (EHR) data was used to measure the number of medical visits or mental health (MH) visit days, following 12 months from the calculated All of Us Frailty Index. Analyses adjusted for age, race and ethnicity, income, HIV, marital status ± general MH (only MH analyses).

resultsCompared to non-OSGM, OSGM adults have higher rates of medical visits (adjusted rate ratio [aRR]: 1.14; 95% CI: 1.03, 1.24) and MH visits (aRR: 1.85; 95% CI: 1.07, 2.91). Frailty mediated the association between OSGM status medical visits (Controlled direct effect [Rcde] aRR: 1.03, 95% CI [0.87, 1.22]), but not MH visits (Rcde aRR: 0.37 [95% CI: 0.06, 1.47]). Delays mediated the association between OSGM status and MH visit days (Rcde aRR: 2.27, 95% CI [1.15, 3.76]), but not medical visits (Rcde aRR: 1.06 [95% CI: 0.97, 1.17]). DISCUSSION: Frailty represents a need for medical care among OSGM adults, highlighting the importance of addressing it to improve health and healthcare utilization disparities. In contrast, healthcare delays are a barrier to MH care, underscoring the necessity of targeted strategies to ensure timely MH care for OSGM adults.

Indexed as

Patient Acceptance of Health CareSexual and Gender MinoritiesAgedFemaleFrailtyHumansMaleMiddle AgedTime-to-TreatmentUnited Stateselectronic health recordsfrailtyhealthcare delayshealthcare utilizationolder adultsexual and gender minority

Identifiers

PMID39078278
PMCPMC11631129

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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.