Abstract Details

Title A Systematic Scoping Review and Qualitative Analysis of Research on Disparities in the Clinical Provision of Deep Brain Stimulation

Topic Movement Disorders

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

Poster/Presentation
Number 3-020

Objective Systematically survey the literature on sources of disparity in the clinical provision of deep brain stimulation (DBS) therapy; assess literature quality; synthesize and integrate findings to identify broad trends and knowledge gaps and generate hypotheses for future research.

Background DBS is used to treat a variety of neurologic and psychiatric conditions, such as Parkinson’s disease, epilepsy, and obsessive-compulsive disorder. However, despite strong evidence supporting its efficacy and inclusion in standardized treatment guidelines, there exist inequalities in the implementation, access, and use of DBS.

Design/Methods We conducted a systematic literature search in PubMed, Embase, and Web of Science. There were no restrictions on publication period or location of study. Any English study that assessed how social determinants of health (including socioeconomic status, race, gender, primary language, and educational level) were associated with disparities in the provisioning of DBS were included for analysis. We conducted a qualitative analysis using Grounded Theory methodology to identify and map themes in the methodology of these studies and interpretation of findings. Critical appraisal of evidence quality and risk of bias was also conducted using several validated tools.

Results The search identified 1960 studies that underwent title/abstract screening. 148 studies underwent full-text review, which resulted in 50 studies meeting inclusion criteria for data extraction. Preliminary findings indicate that individuals who reported female gender, Black or African American race, low socioeconomic status, or non-private insurance were associated with decreased access or utilization of DBS therapy. Studies were appraised to be generally of moderate to low quality. Qualitative analysis of methodologies and interpretation reveals synthetic themes not apparent in individual studies.

Conclusions Gender, race, socioeconomic status, and insurance status are associated with disparities in the clinical provision of DBS. Shared methodologies weaken the findings of this body of this literature. Qualitative synthesis may re-orient hypotheses for future research in DBS disparities.

Authors/Disclosures
Wellington Chang PRESENTER	Mr. Chang has nothing to disclose.
Talia Ganz (USC)	No disclosure on file
Sara Kang	No disclosure on file
Rachael Garner	No disclosure on file
Kacey Hu, MD	Dr. Hu has nothing to disclose.
Wesley Gong	No disclosure on file
Adam Frank (University of Southern California)	No disclosure on file
Xenos Mason, MD (University of Southern California)	Dr. Mason has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Mason has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott Labs. Dr. Mason has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Janssen .

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