Abstract Details

Title Evaluating Disparities in Neurological Clinical Decision Making by Race/Ethnicity: Utilizing a Scorecard to Assess Local Practice Patterns

Topic Health Care Disparities

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-014

Objective Personalized data could benefit clinicians seeking to ensure equity in their clinical decisions. A scorecard is a convenient way to communicate this information both to clinician and to the communities in which they practice.

Background

Racial/ethnic health disparities are common throughout Neurology, and clinical decisions contribute to these disparities.

Design/Methods One binary clinical decision point was analyzed for each division within an academic neurology center. The percentage of patients who received each intervention was stratified by race/ethnicity and compared to identify any disparities in care.

Results There was a statistically significant disparity between Black and White patients in treatment of acute ischemic stroke with White patients about 30% more likely to receive alteplase than Black patients. There was also a disparity in patients with epilepsy with non-Hispanic patients being roughly 5 times more likely than Hispanic patients to be referred to Neurosurgery, with an estimated OR=4.9 and 95% CI (2.1,11.6). No other disparities were identified. This resulted in scored grades of 5 As and 2 Bs.

Conclusions The use of a scorecard to report disparities data can provide incentive for clinicians to investigate their practices for causes of the disparities while building trust and transparency with their communities.

Authors/Disclosures
Roshni Dhoot, MD (Roshni Dhoot) PRESENTER	Dr. Dhoot has nothing to disclose.
Deborah Rose, MD	Dr. Rose has nothing to disclose.
Shakthi Unnithan	No disclosure on file
Danelvis Paredes, MD	Dr. Paredes has nothing to disclose.
Meenakshi Roy, MD (Rush University Medical Center, Department of Neurology)	Dr. Roy has nothing to disclose.
Hunter Roark, DO (Duke University Hospital)	Dr. Roark has nothing to disclose.
Petra Brayo, MD	Dr. Brayo has nothing to disclose.
Hussein Al-Khalidi (Duke University)	No disclosure on file
Andrew R. Spector, MD, FAAN	Dr. Spector has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Noctrix. Dr. Spector has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Apnimed. Dr. Spector has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Today. Dr. Spector has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology: Clinical Practice. Dr. Spector has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Shevlin Smith. Dr. Spector has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Armstrong Teasdale. The institution of an immediate family member of Dr. Spector has received research support from NIH/NIAID. The institution of an immediate family member of Dr. Spector has received research support from AAAAI Foundation. The institution of an immediate family member of Dr. Spector has received research support from Thurston Arthritis Research Center at UNC. Dr. Spector has received publishing royalties from a publication relating to health care.

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