Evidence mapPaperPMID 29398299Full record

ArticleAnnals of epidemiology2018

Racial differences in spatial patterns for poor glycemic control in the Southeastern United States.

Rebekah J Walker, Brian Neelon, Melanie Davis, Leonard E Egede

Open access · greenAbstract read
In one paragraph

Article in Annals of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

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  2. 2021 Community Engagement Studio Virtual Training Summit: Increasing the Diversity of Stakeholders Engaged in Research.Progress in community health partnerships : research, education, and action · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Rebekah J WalkerDivision of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee; Center for Patient Care and Outcomes Research (PCOR), Medical College of Wisconsin, Milwaukee.
Brian NeelonHealth Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC; Department of Public Health Sciences, Medical University of South Carolina, Charleston.
Melanie DavisHealth Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC; Department of Public Health Sciences, Medical University of South Carolina, Charleston.
Leonard E EgedeDivision of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee; Center for Patient Care and Outcomes Research (PCOR), Medical College of Wisconsin, Milwaukee. Electronic address: legede@mcw.edu.
Medical College of Wisconsin · USMedical University of South Carolina · US

Funding

HSRD VA I50 HX001229NIDDK NIH HHS K24 DK093699
6 · The paper itself

Abstract

purposeEvidence consistently shows poor outcomes in racial minorities, but there is limited understanding of differences that are explained by spatial variation. The goal of this analysis was to examine contribution of spatial patterns on disparities in diabetes outcomes in the Southeastern United States.

methodsData on 64,022 non-Hispanic black (NHB) and non-Hispanic white (NHW) veterans with diabetes living in Georgia, Alabama, and South Carolina were analyzed for 2014. Hemoglobin A1c (HbA1c) was categorized as controlled (less than 8%) and uncontrolled (greater than or equal to 8%). Logistic regression was used to understand the additional explanatory capability of spatial random effects over covariates such as demographics, service connectedness, and comorbidities. Data aggregated at the county level were used to identify hotspots in distribution of uncontrolled HbA1c and tested using local Moran's I test.

resultsOverall percent uncontrolled HbA1c was 36.5% (40.8% in NHB and 33.4% in NHW). In unadjusted analyses, NHB had 37% higher odds of uncontrolled HbA1c (odds ratio [OR]: 1.37, 95% confidence interval, 1.32, 1.41). After adjusting for demographics and comorbidities, the OR decreased to 1.09 but remained significant (95% confidence interval, 1.05, 1.13). The OR further decreased after incorporating spatial effects (OR: 1.07, 95% confidence interval, 1.03, 1.11) but remained statistically significant. Hotspots of high HbA1c were detected, and spatial patterns differed across racial groups.

conclusionsDifferences in spatial patterns in glycemic control exists between NHB and NHW veterans with type 2 diabetes. Incorporating spatial effects helps explain more of the disparity in uncontrolled HbA1c than adjusting only for demographics and comorbidities, but significant differences in uncontrolled HbA1c remained.

Indexed as

Spatial AnalysisAgedAged, 80 and overAlabamaBlack or African AmericanBlack PeopleBlood GlucoseDiabetes Mellitus, Type 2FemaleGeorgiaGlycated HemoglobinHispanic or LatinoHumansHypoglycemic AgentsInsulinMaleBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinDiabetesDisparitiesRacial/ethnic differencesSpatial variation

Identifiers

PMID29398299
PMCPMC5828989
OpenAlexW2784016203

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.