Evidence map›Paper›PMID 39420596›Full record

ArticleESC heart failure2025

Association between clinician team segregation, receipt of cardiovascular care and outcomes in valvular heart diseases.

Ikeoluwapo Kendra Bolakale-Rufai, Shannon M Knapp, Janina Quintero Bisono, Adedoyin Johnson, Wanda Moore, Ekow Yankah, Ryan Yee, Dalancee Trabue, Brahmajee Nallamothu, John M Hollingsworth and 16 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

26 authors.

Ikeoluwapo Kendra Bolakale-RufaiDivision of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.ORCID https://orcid.org/0000-0002-5994-8010
Shannon M KnappDivision of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.
Janina Quintero BisonoDepartment of Internal Medicine, Indiana University, Indianapolis, Indiana, USA.
Adedoyin JohnsonDepartment of Internal Medicine, Indiana University, Indianapolis, Indiana, USA.
Wanda MooreSarver Heart Center Minority Outreach Program, University of Arizona, Tucson, Arizona, USA.
Ekow YankahDepartment of Law and Philosophy, University of Michigan, Ann Arbor, Michigan, USA.
Ryan YeeDivision of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.
Dalancee TrabueDivision of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.
Brahmajee NallamothuDivision of Cardiovascular Diseases, University of Michigan, Ann Arbor, Michigan, USA.
John M HollingsworthQuality Department, Endeavor Health NorthShore Hospitals, Evanston, Illinois, USA.
Stephen WattyDepartment of Internal Medicine, Indiana University, Indianapolis, Indiana, USA.
Francesca WilliamsonDepartment of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Natalie PoolSchool of Nursing, University of Northern Colorado, Greeley, Colorado, USA.
Megan HebdonSchool of Nursing, University of Texas at Austin, Austin, Texas, USA.
Nneamaka EzemaDivision of Clinical Trials Operations Management, Nex Gen Research, Dayton, Ohio, USA.
Quinn CapersDepartment of Medicine, Howard University College of Medicine, Washington, D.C., USA.
Courtland BlountDivision of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.
Nia KimbroughSisters Together Centers of Wellness for Urban Women, Indianapolis, Indiana, USA.
Denee JohnsonIndiana University Health, Indianapolis, Indiana, USA.
Jalynn EvansIndiana University Health, Indianapolis, Indiana, USA.
Brandi ForeeIndiana University Health, Indianapolis, Indiana, USA.
Anastacia HolmanDivision of Chaplaincy Education, IU Health System, Indianapolis, Indiana, USA.
Karen LightbourneDivision of Community Networks collaborations for the East Region, Indianapolis, Indiana, USA.
David BrownDepartment of Otolaryngology-Head and Neck Surgery and Pediatric Otolaryngology, Michigan Medicine, Ann Arbor, Michigan, USA.
Brownsyne Tucker EdmondsIndiana University Health, Indianapolis, Indiana, USA.
Khadijah BreathettDivision of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.ORCID https://orcid.org/0000-0001-5397-6419

Funding

Reducing Ethnic-racial Disparities in Cardiac Arrest Survival Outcomes (RED-CASO)R01HL160734 · NHLBI · SAINT LUKE'S HOSPITAL · PI CHAN, PAUL SHEUNG-YAN, GIROTRA, SAKET · 2022 to 2025
$2.6M
Seeking Objectivity in Allocation of Advanced Heart Failure (SOCIAL HF) Therapies TrialR01HL159216 · NHLBI · INDIANA UNIVERSITY INDIANAPOLIS · PI BREATHETT, KHADIJAH · 2022 to 2025
$2.6M
Addressing Individual Provider Bias and Group Decision-Making in Selection of Advanced Heart Failure Therapies in Racial/Ethnic MinoritiesK01HL142848 · NHLBI · UNIVERSITY OF ARIZONA · PI BREATHETT, KHADIJAH · 2018 to 2021
$858k
NHLBI NIH HHS K01 HL142848NHLBI NIH HHS K01HL142848NHLBI NIH HHS R01 HL159216NHLBI NIH HHS R01HL159216NHLBI NIH HHS R01 HL160734NHLBI NIH HHS R01HL160734US Department of Health and Human Services
6 · The paper itself

Abstract

aimsRacial disparities exist in clinical outcomes for valvular heart disease (VHD). It is unknown whether clinician segregation contributes to these disparities. Among an adequately insured population, we evaluated the relationship between clinician segregation in a hospital and receipt of care by a cardiologist according to patient race. We also evaluated the association between clinician segregation, race and care by a cardiologist on 30-day readmission and 1-year survival. METHODS AND

resultsUsing Optum's Clinformatics® Data Mart Database (CDM, US commercial and Medicare beneficiaries) from 2010 to 2018, we identified patients with a primary diagnosis of VHD. Hospitals were categorized into low, medium and high segregation groups (SG), according to clinician segregation index (SI). SI can range from 0-1 (0: the ratio of Black to White patients is the same for all clinicians; 1: each clinician treats only Black or only White patients). Outcomes were analysed using generalized linear mixed effect models. Among 8649 patients [median age 75 (67-82), 45.4% female, 16.1% Black, 83.9% White], odds of care from a cardiologist did not vary across race for all SGs [Low SG adjusted odds ratio (aOR): 0.79 (95% CI: 0.58-1.08), P = 0.14; Medium SG aOR: 0.86 (95% CI: 0.60-1.25), P = 0.43; High SG aOR: 1.07 (95% CI: 0.68-1.69), P = 0.76]. Among those that received care from a cardiologist, there was no difference in the 30-day readmission between Black and White patients across SGs [Low SG aOR: 1.05 (95% CI: 0.83-1.31), P = 0.70; Medium SG aOR: 1.22 (95% CI: 0.92-1.61), P = 0.17; High SG aOR: 0.81 (95% CI: 0.57-1.17), P = 0.27]. Among patients that did not receive care from a cardiologist, Black patients in low SG had higher odds of 30-day readmission compared to White patients [aOR: 2.74 (95%CI:1.38-5.43), P < 0.01]. Odds of 1-year survival were similar across race for all SG irrespective of receipt of care from a cardiologist [seen by a cardiologist: Low SG aOR: 1.13 (95% CI: 0.86-1.48), P = 0.38; Medium SG aOR: 0.83 (95% CI: 0.59-1.17), P = 0.29; High SG aOR: 1.01 (95% CI: 0.66-1.52), P = 0.98; not seen by a cardiologist: Low SG aOR: 0.56 (95% CI: 0.23-1.34), P = 0.19; Medium SG aOR: 0.81 (95% CI: 0.28-2.37), P = 0.70; High SG aOR: 0.63 (95% CI: 0.23-1.74), P = 0.37].

conclusionsAmong an insured population, race was not associated with care by a cardiologist for VHD or survival. Black patients not seen by cardiologists had higher odds of 30-day readmission in low clinician SG.

Indexed as

CardiologistsHealthcare DisparitiesHeart Valve DiseasesPatient Care TeamAgedAged, 80 and overFemaleFollow-Up StudiesHumansMalePatient ReadmissionRetrospective StudiesSurvival RateUnited Statescardiovascular diseaseshealth equityquality of careracial disparitiessegregation indexstructural racism

Identifiers

PMID39420596
PMCPMC11769615

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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.