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Emily Parker, BS
Pronouns
She/Her/Hers
Job Title
Research Assistant
Academic Rank
Department
Orthopedics
Authors
Emily B. Parker BS, Lorraine A. Boakye MD, Elizabeth A. Martin MD, Christopher P. Chiodo MD, Eric M. Bluman MD PhD, Jeremy T. Smith MD
Principal Investigator
Jeremy T. Smith MD
Research Category: Musculoskeletal/Orthopedics/Sports Medicine
Tags
Despite decades of research, policy reforms, and national initiatives, racial and ethnic care disparities persist within orthopaedics. This study aims to deepen our understanding of sociodemographic factors driving racial and ethnic disparities in PROM scores and determine which factors may be predominantly driving score variation.
We retrospectively reviewed baseline PROMIS Global-Physical (PGP) and PROMIS Global-Mental (PGM) scores of 23,171 foot and ankle patients from 2016-2021. Multivariable regression models were used to evaluate changes in scores by race and ethnicity upon adjusting for inequities in household income, education level, primary language, CCI, sex, and age. Full models were utilized to compare independent effects of predictors.
For PGP and PGM, adjusting for income, education level, and CCI reduced the racial disparity by 61% and 54%, respectively, and adjusting for education level, language, and income reduced the ethnic disparity by 67% and 65%, respectively. Full models revealed education level of high school or less and severe CCI had the largest negative effects on scores.
Inequities in education level, primary language, income, and CCI explained the majority (but not all) of the racial and ethnic disparities in our cohort. Among the explored factors, education level and CCI were predominant drivers of PROM score variation.
Despite decades of research, policy reforms, and national initiatives, racial and ethnic care disparities persist within orthopaedics. This study aims to deepen our understanding of sociodemographic factors driving racial and ethnic disparities in PROM scores and determine which factors may be predominantly driving score variation.
We retrospectively reviewed baseline PROMIS Global-Physical (PGP) and PROMIS Global-Mental (PGM) scores of 23,171 foot and ankle patients from 2015-2021. Statistical models were used to evaluate changes in scores by race and ethnicity upon adjusting for inequities in household income, education level, primary language, comorbidities, sex, and age. Full models were utilized to compare independent effects of each factor.
For PGP and PGM, adjusting for income, education level, and comorbidities reduced the racial disparity by 61% and 54%, respectively, and adjusting for education level, language, and income reduced the ethnic disparity by 67% and 65%, respectively. Full models revealed education level of high school or less and severe comorbidities had the largest negative effects on scores.
Inequities in education level, primary language, income, and comorbidities explained the majority (but not all) of the racial and ethnic disparities in our cohort. Among the explored factors, education level and comorbidities were predominant drivers of PROM score variation.
