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Miller JS, Oladele F, McAfee D, Adereti CO, Theodore WH, Akinsoji EO. Disparities in Epilepsy Diagnosis and Management in High-Income Countries: A Review of the Literature. Neurol Clin Pract 2024; 14:e200259. [PMID: 38585438 PMCID: PMC10996906 DOI: 10.1212/cpj.0000000000200259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/20/2023] [Indexed: 04/09/2024]
Abstract
Purpose of Review Currently, an estimated 3.4 million people in the United States live with epilepsy. Previous studies have identified health disparities associated with race/ethnicity, socioeconomic status (SES), sex, insurance status, and age in this population. However, there has been a dearth of research addressing these disparities. We performed a literature review of articles published between 2010 and 2020 pertaining to health disparities in people with epilepsy (PWE), identified key factors that contribute to gaps in their care, and discussed possible solutions. Recent Findings Health disparities in prevalence, treatment access, time to diagnosis, health care delivery and engagement, and clinical outcomes were identified among individuals who were either of low SES, rural-based, uninsured/underinsured, older patients, patients of color, or female sex. Summary Disparities in care for PWE continue to persist. Greater priority should be placed on addressing these gaps intricately tied to sociodemographic factors. Reforms to mitigate health disparities in PWE are necessary for timely diagnosis, effective treatment, and positive long-term outcomes.
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Affiliation(s)
- Joseph S Miller
- Ohio University Heritage College of Osteopathic Medicine (JSM), Dublin, OH; Memorial Sloan Kettering Cancer Center (FO), New York; University of Maryland School of Medicine (DM), Baltimore, MD; Ross University School of Medicine (COA); National Institute of Neurological Disorders and Stroke (WHT), National Institutes of Health, Bethesda, MD; and Department of Neurology (EOA), Emory University School of Medicine, Atlanta, GA
| | - Folake Oladele
- Ohio University Heritage College of Osteopathic Medicine (JSM), Dublin, OH; Memorial Sloan Kettering Cancer Center (FO), New York; University of Maryland School of Medicine (DM), Baltimore, MD; Ross University School of Medicine (COA); National Institute of Neurological Disorders and Stroke (WHT), National Institutes of Health, Bethesda, MD; and Department of Neurology (EOA), Emory University School of Medicine, Atlanta, GA
| | - Darrian McAfee
- Ohio University Heritage College of Osteopathic Medicine (JSM), Dublin, OH; Memorial Sloan Kettering Cancer Center (FO), New York; University of Maryland School of Medicine (DM), Baltimore, MD; Ross University School of Medicine (COA); National Institute of Neurological Disorders and Stroke (WHT), National Institutes of Health, Bethesda, MD; and Department of Neurology (EOA), Emory University School of Medicine, Atlanta, GA
| | - Christopher O Adereti
- Ohio University Heritage College of Osteopathic Medicine (JSM), Dublin, OH; Memorial Sloan Kettering Cancer Center (FO), New York; University of Maryland School of Medicine (DM), Baltimore, MD; Ross University School of Medicine (COA); National Institute of Neurological Disorders and Stroke (WHT), National Institutes of Health, Bethesda, MD; and Department of Neurology (EOA), Emory University School of Medicine, Atlanta, GA
| | - William H Theodore
- Ohio University Heritage College of Osteopathic Medicine (JSM), Dublin, OH; Memorial Sloan Kettering Cancer Center (FO), New York; University of Maryland School of Medicine (DM), Baltimore, MD; Ross University School of Medicine (COA); National Institute of Neurological Disorders and Stroke (WHT), National Institutes of Health, Bethesda, MD; and Department of Neurology (EOA), Emory University School of Medicine, Atlanta, GA
| | - Elizabeth O Akinsoji
- Ohio University Heritage College of Osteopathic Medicine (JSM), Dublin, OH; Memorial Sloan Kettering Cancer Center (FO), New York; University of Maryland School of Medicine (DM), Baltimore, MD; Ross University School of Medicine (COA); National Institute of Neurological Disorders and Stroke (WHT), National Institutes of Health, Bethesda, MD; and Department of Neurology (EOA), Emory University School of Medicine, Atlanta, GA
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Kinney MO, Brigo F. What can Google Trends and Wikipedia-Pageview analysis tell us about the landscape of epilepsy surgery over time? Epilepsy Behav 2020; 103:106533. [PMID: 31645311 DOI: 10.1016/j.yebeh.2019.106533] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 08/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Epilepsy surgery is an effective treatment for drug-resistant epilepsy. Some centers have noticed changes in referral patterns. AIM The aim of this study was to determine if online infodemiological data related to epilepsy surgery reflect reported changes in referrals to surgical centers. METHODS Google Trends and Pageview analysis of temporal trends of searches conducted in Google and Wikipedia for epilepsy surgery, using key search terms such as "epilepsy surgery" and terms related to pathology, operation type, and investigative practice. RESULTS Over the 15-year time period studied by Google trend analysis, when the initial three-year epoch and final three-year epoch are compared, a 56.1% decline in search volume for "epilepsy surgery" was observed. Vagus nerve stimulation and laser ablation are increasingly searched items. Pageview analysis shows that temporal lobe epilepsy remains the most commonly searched subtype of epilepsy and hippocampal sclerosis was searched for more than focal cortical dysplasia. CONCLUSION This study suggests a lower search interest over time in epilepsy surgery, and various associated terms, with increased interest in vagus nerve stimulation and laser ablation procedures over time. There is no clear indication from these data regarding the apparent shift from mesial temporal cases to an increase in extratemporal case workload.
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Affiliation(s)
- Michael Owen Kinney
- Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
| | - Francesco Brigo
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Division of Neurology, "Franz Tappeiner" Hospital, Merano, Italy
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Arya R, Rutka JT. Pediatric epilepsy surgery: Toward increased utilization and reduced invasiveness. Neurology 2018; 90:401-402. [PMID: 29386272 DOI: 10.1212/wnl.0000000000005036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Ravindra Arya
- From the Comprehensive Epilepsy Center (R.A.), Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and Division of Neurosurgery (J.T.R.), The Hospital for Sick Children, Toronto, Canada.
| | - James T Rutka
- From the Comprehensive Epilepsy Center (R.A.), Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and Division of Neurosurgery (J.T.R.), The Hospital for Sick Children, Toronto, Canada
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