Ethnic and Gender Disparities in Access to Deep Brain Stimulation Surgery for Parkinson's Disease
Bibliographic record
Abstract
BACKGROUND: Deep brain stimulation (DBS) is an established treatment for Parkinson's disease (PD) in appropriately selected patients. DBS may be underused in certain patient populations, especially women and racialized groups. Barriers and biases to receiving DBS that could account for underuse among these groups are not well studied in Canada. OBJECTIVE: We aim to better characterize the disparities in gender, ethnicity and other demographic factors among patients referred for and receiving DBS. METHODS: We performed a retrospective chart review and phone survey of DBS patients treated at two Canadian centers and from Canada Open Parkinson Network (C-OPN). Gender, ethnicity, marital status, native language, birth country, urban versus rural residency, level of education, household income and mode of referral were studied. RESULTS: Among all participants, more men than women received DBS. Most patients (81.8-94.1%) in both referral and implanted groups were White. The gender and ethnicity of this cohort do not represent Canadian demographics. Patients referred and receiving surgery had higher educational level compared with general Canadian population. Being married was positively associated with DBS referral and implantation. CONCLUSION: Significant ethnic and gender disparities in receiving DBS exist. Educated White men were overrepresented. Further actions need to be taken to expand the accessibility of this important treatment to all eligible PD patients with an effort to provide equitable care to women, racialized groups and those who cannot advocate for themselves in Canada.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".