ArticleWomen's health (London, England)
Sequential pathway analysis of sex differences in deep brain stimulation for Parkinson's disease.
Article in Women's health (London, England). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
ObjectivesDeep brain stimulation (DBS) is a well-established treatment for Parkinson's disease (PD). Despite its proven efficacy, women are less likely to receive DBS. This study examined sex differences across the multistage clinical pathway to identify stage-specific factors contributing to disparities in utilization.DesignRetrospective cohort study using longitudinal clinical data from a single, high-volume neurological care center.MethodsData were drawn from 4,308 patients with PD treated between 2012 and 2024. Progression through the DBS pathway was modeled as four conditional stages: (S1) referral, (S2) multidisciplinary evaluation among those referred, (S3) recommendation among those evaluated, and (S4) DBS surgery among those recommended. Stage-specific Firth penalized logistic regression models were used to estimate sex differences while adjusting for demographic and clinical characteristics, including age, race, comorbidities, marital status, levodopa use, and tremor status. Sex-by-predictor interactions were assessed to identify differential effects across stages.ResultsAmong the cohort (2,866 males, 1,442 females), 186 (4.3%) received a referral for evaluation; 180 (97%) received an evaluation; and 159 (88%) received DBS. Adjusting only for sex, compared to males, females were less likely to be referred (OR=0.97, CI=0.71, 1.32), evaluated given referral (OR=0.88, CI=0.1, 5.17), and receive DBS given recommendation (OR=0.61, CI=0.17, 2.38), but more likely to receive a recommendation after evaluation (OR = 1.55, CI = 0.59-4.70). Sex-Predictors odds ratios differed [male- S1: age (OR=0.95, CI=0.93, 0.97), comorbidities (OR=1.19, CI=1.00, 1.41); S2: comorbidities (OR=0.51, CI=0.20, 0.87); S3: age (OR=0.91, CI=0.84, 0.97), non-white (OR=0.29, CI=0.09, 0.88), comorbidities (OR=1.90, CI=1.09, 3.73); S4: non-white (OR=0.15, CI=0.02, 0.91); [females- S1: unmarried (OR=0.71, CI=0.38, 0.92); S2: levodopa (OR=1.24, CI=1.06, 1.90); S3: non-white (OR=0.01, CI=0.00, 0.31); S4: tremors (OR=1.55, CI=1.04, 1.87)].ConclusionStage-specific regression showed that differential characteristics were associated with sex disparities in DBS utilization, highlighting potential targets for equity interventions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.