scholarly journals Massachusetts general hospital Covid-19 registry reveals two distinct populations of hospitalized patients by race and ethnicity

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244270
Author(s):  
Ingrid V. Bassett ◽  
Virginia A. Triant ◽  
Bridget A. Bunda ◽  
Caitlin A. Selvaggi ◽  
Daniel J. Shinnick ◽  
...  
Keyword(s):  
General Hospital ◽  
Race And Ethnicity ◽  
Massachusetts General Hospital ◽  
Data Extraction ◽  
Hospitalized Patients ◽  
Health Records ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Adjusted Model ◽  
Multivariable Adjusted Model

Objective To evaluate differences by race/ethnicity in clinical characteristics and outcomes among hospitalized patients with Covid-19 at Massachusetts General Hospital (MGH). Methods The MGH Covid-19 Registry includes confirmed SARS-CoV-2-infected patients hospitalized at MGH and is based on manual chart reviews and data extraction from electronic health records (EHRs). We evaluated differences between White/Non-Hispanic and Hispanic patients in demographics, complications and 14-day outcomes among the N = 866 patients hospitalized with Covid-19 from March 11, 2020—May 4, 2020. Results Overall, 43% of patients hospitalized with Covid-19 were women, median age was 60.4 [IQR = (48.2, 75)], 11.3% were Black/non-Hispanic and 35.2% were Hispanic. Hispanic patients, representing 35.2% of patients, were younger than White/non-Hispanic patients [median age 51y; IQR = (40.6, 61.6) versus 72y; (58.0, 81.7) (p<0.001)]. Hispanic patients were symptomatic longer before presenting to care (median 5 vs 3d, p = 0.039) but were more likely to be sent home with self-quarantine than be admitted to hospital (29% vs 16%, p<0.001). Hispanic patients had fewer comorbidities yet comparable rates of ICU or death (34% vs 36%). Nonetheless, a greater proportion of Hispanic patients recovered by 14 days after presentation (62% vs 45%, p<0.001; OR = 1.99, p = 0.011 in multivariable adjusted model) and fewer died (2% versus 18%, p<0.001). Conclusions Hospitalized Hispanic patients were younger and had fewer comorbidities compared to White/non-Hispanic patients; despite comparable rates of ICU care or death, a greater proportion recovered. These results have implications for public health policy and the design and conduct of clinical trials.

scholarly journals Massachusetts General Hospital Covid-19 Registry reveals two distinct populations of hospitalized patients by race and ethnicity

2020 ◽  
Author(s):  
Ingrid V Bassett ◽  
Virgina A Triant ◽  
Bridget A Bunda ◽  
Caitlin A Selvaggi ◽  
Daniel J Shinnick ◽  
...  
Keyword(s):  
General Hospital ◽  
Race And Ethnicity ◽  
Massachusetts General Hospital ◽  
Data Extraction ◽  
Hospitalized Patients ◽  
Health Records ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Adjusted Model ◽  
Multivariable Adjusted Model

Objective: To evaluate differences by race/ethnicity in clinical characteristics and outcomes among hospitalized patients with Covid-19 at Massachusetts General Hospital (MGH). Methods: The MGH Covid-19 Registry includes confirmed SARS-CoV-2-infected patients hospitalized at MGH and is based on manual chart reviews and data extraction from electronic health records (EHRs). We evaluated differences between White/Non-Hispanic and Hispanic patients in demographics, complications and 14-day outcomes among the N=866 patients hospitalized with Covid-19 from March 11, 2020 - May 4, 2020. Results: Overall, 43% of patients hospitalized with Covid-19 were women, median age was 60.4 [IQR = (48.2, 75)], 11.3% were Black/non-Hispanic and 35.2% were Hispanic. Hispanic patients, representing 35.2% of patients, were younger than White/non-Hispanic patients [median age 51y; IQR = (40.6, 61.6) versus 72y; (58.0, 81.7) (p<0.001)]. Hispanic patients were symptomatic longer before presenting to care (median 5 vs 3d, p=0.039) but were more likely to be sent home with self-quarantine than be admitted to hospital (29% vs 16%, p<0.001). Hispanic patients had fewer comorbidities yet comparable rates of ICU or death (34% vs 36%). Nonetheless, a greater proportion of Hispanic patients recovered by 14 days after presentation (62% vs 45%, p<0.001; OR = 1.99, p = 0.011 in multivariable adjusted model) and fewer died (2% versus 18%, p<0.001). Conclusions: Hospitalized Hispanic patients were younger and had fewer comorbidities compared to White/non-Hispanic patients; despite comparable rates of ICU care or death, a greater proportion recovered. These results have implications for public health policy and the design and conduct of clinical trials.

scholarly journals Racial and Ethnic Enrollment Disparities and Demographic Reporting Requirements in Acute Leukemia Clinical Trials

2021 ◽  
Author(s):  
Andrew Hantel ◽  
Marlise R. Luskin ◽  
Jacqueline S Garcia ◽  
Wendy Stock ◽  
Daniel J DeAngelo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Native American ◽  
Acute Leukemia ◽  
Race And Ethnicity ◽  
Disease Incidence ◽  
The United States ◽  
Reporting Requirements ◽  
Number Of Patients ◽  
Hispanic Patients ◽  
Race Ethnicity

Data regarding racial and ethnic enrollment diversity for acute myeloid (AML) and lymphoid leukemia (ALL) clinical trials in the United States (US) are limited, and little is known about the effect of federal reporting requirements instituted in the late 2000s. We examined demographic data reporting and enrollment diversity for US ALL and AML trials from 2002-2017 as well as changes in reporting and diversity after reporting requirements were instituted. Of 223 AML and 97 ALL trials with results, 68 (30.5%) and 51 (52.6%) reported enrollment by both race and ethnicity. Among trials that reported race and ethnicity (AML N=6,554; ALL N=4,149), non-Hispanic (NH)-Black, NH-Native American, NH-Asian, and Hispanic patients had significantly lower enrollment compared to NH-white patients after adjusting for race-ethnic disease incidence (AML odds: 0.68, 0.31, 0.75, and 0.83; ALL: 0.74, 0.27, 0.67, and 0.64; all p≤0.01). The proportion of trials reporting race increased significantly after the reporting requirements (44.2 to 60.2%; p=0.02), but race-ethnicity reporting did not (34.8 to 38.6%; p=0.57). Reporting proportions by number of patients enrolled increased significantly after the reporting requirements (race: 51.7 to 72.7%, race-ethnicity: 39.5 to 45.4%; both p&lt;0.001), and relative enrollment of NH-Black and Hispanic patients decreased (AML odds: 0.79 and 0.77; ALL: 0.35 and 0.25; both p≤0.01). These data suggest that demographic enrollment reporting for acute leukemia trials is suboptimal, changes in diversity after the reporting requirements may be due to additional enrollment disparities that were previously unreported, and enrollment diversification strategies specific to acute leukemia care delivery are needed.

Abstract 16459: Racial and Ethnic Differences in Echocardiographic Abnormalities and Myocardial Injury in Patients With Covid-19: The CIRC-19 Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michael S Miller ◽  
Gennaro Giustino ◽  
Annapoorna Kini ◽  
Giulio Stefanini ◽  
Renato Bragato ◽  
...  
Keyword(s):  
New York ◽  
Hospital Mortality ◽  
Race And Ethnicity ◽  
Myocardial Injury ◽  
Minority Groups ◽  
Racial And Ethnic Differences ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Hispanic Patients ◽  
Race Ethnicity

Introduction: Myocardial injury is common amongst patients hospitalized with Covid-19 and is associated with a poor prognosis. It is unknown whether its incidence and its mechanisms differ by race and ethnicity. Methods: We conducted a multicenter, international cohort study at 7 hospitals in New York (United States) and Milan (Italy) between March and May 2020. All patients were hospitalized, had laboratory-confirmed Covid-19, and received a transthoracic echocardiogram (TTE) during their hospitalization. We evaluated the association between race/ethnicity and myocardial injury in multivariable logistic regression models. Myocardial injury was defined as any cardiac troponin elevation above the upper limit of normal at each enrolling site. Results: A total of 305 consecutive patients were included, of whom 280 had self-reported race/ethnicity. Key demographic, laboratory and echocardiographic characteristics are presented in the Table. All minority groups had higher incidence of a composite of major echocardiographic abnormalities compared to whites, and Asian and Hispanic patients had increased incidence of RV dysfunction. In multivariable models, compared with Whites, Black (adjOR 2.7 [1.1-6.4]), Asian (adjOR 3.3 [1.1-10.2]), and Hispanic (adjOR 2.8 [1.4-5.8]) patients had increased odds of myocardial injury. After adjusting for baseline demographic and clinical variables, both Asian (adjOR 9.9 [2.6-38.6]) and Hispanic (adjOR 5.7 [2.1-15.6]) patients had increased odds of in-hospital mortality compared with White, but not Black (adjOR 2.0 [0.6-7.0]) patients. Conclusions: Among hospitalized patients with Covid-19 who received a TTE, minority groups had higher incidence of echocardiographic abnormalities and increased risk of myocardial injury. After adjustment for baseline confounders, only Asian and Hispanic patients remained at increased risk for in-hospital mortality.

scholarly journals Underserved populations with missing race ethnicity data differ significantly from those with structured race/ethnicity documentation

2019 ◽  
Vol 26 (8-9) ◽  
pp. 722-729 ◽  
Author(s):  
Evan T Sholle ◽  
Laura C Pinheiro ◽  
Prakash Adekkanattu ◽  
Marcos A Davila ◽  
Stephen B Johnson ◽  
...  
Keyword(s):  
Language Processing ◽  
Race And Ethnicity ◽  
Primary Care Practice ◽  
Underserved Populations ◽  
Care Practice ◽  
Rule Based ◽  
Clinical Notes ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Ethnicity Data

Abstract Objective We aimed to address deficiencies in structured electronic health record (EHR) data for race and ethnicity by identifying black and Hispanic patients from unstructured clinical notes and assessing differences between patients with or without structured race/ethnicity data. Materials and Methods Using EHR notes for 16 665 patients with encounters at a primary care practice, we developed rule-based natural language processing (NLP) algorithms to classify patients as black/Hispanic. We evaluated performance of the method against an annotated gold standard, compared race and ethnicity between NLP-derived and structured EHR data, and compared characteristics of patients identified as black or Hispanic using only NLP vs patients identified as such only in structured EHR data. Results For the sample of 16 665 patients, NLP identified 948 additional patients as black, a 26%increase, and 665 additional patients as Hispanic, a 20% increase. Compared with the patients identified as black or Hispanic in structured EHR data, patients identified as black or Hispanic via NLP only were older, more likely to be male, less likely to have commercial insurance, and more likely to have higher comorbidity. Discussion Structured EHR data for race and ethnicity are subject to data quality issues. Supplementing structured EHR race data with NLP-derived race and ethnicity may allow researchers to better assess the demographic makeup of populations and draw more accurate conclusions about intergroup differences in health outcomes. Conclusions Black or Hispanic patients who are not documented as such in structured EHR race/ethnicity fields differ significantly from those who are. Relatively simple NLP can help address this limitation.

scholarly journals Disparities in Pediatric Epilepsy Remission Are Associated With Race and Ethnicity

2019 ◽  
Vol 34 (14) ◽  
pp. 928-936 ◽  
Author(s):  
Celestine H. Yeung Gregerson ◽  
Amanda V. Bakian ◽  
Jacob Wilkes ◽  
Andrew J. Knighton ◽  
Flory Nkoy ◽  
...  
Keyword(s):  
Health Care ◽  
Race And Ethnicity ◽  
Care Delivery ◽  
Socioeconomic Background ◽  
Pediatric Epilepsy ◽  
Seizure Freedom ◽  
Hispanic Ethnicity ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Socioeconomic And Demographic Factors

Objective: The purpose of our study was to assess whether race/ethnicity was associated with seizure remission in pediatric epilepsy. Methods: This was a retrospective population-based cohort study of children who were evaluated for new-onset epilepsy in the clinic, emergency department, and/or hospital by a pediatric neurologist in an integrated health care delivery system. Children were between ages 6 months and 15 years at their initial presentation of epilepsy. The cohort, identified through an electronic database, was assembled over 6 years, with no less than 5 years of follow-up. All children were evaluated for race, ethnicity, insurance type, and socioeconomic background. Patient outcome was determined at the conclusion of the study period and categorized according to their epilepsy control as either drug resistant (pharmacoresistant and intractable) or drug responsive (controlled, probable remission, and terminal remission). Results: In the final cohort of 776 patients, 63% were drug responsive (control or seizure remission). After controlling for confounding socioeconomic and demographic factors, children of Hispanic ethnicity experienced reduced likelihood (hazard) of drug-responsive epilepsy (hazard ratio 0.6, P < .001), and had longer median time to remission (8 years; 95% CI 5.9-9.6 years) compared to white non-Hispanic patients (5.6 years; 95% CI 4.9-6.1 years). Among Hispanic patients, higher health care costs were associated with reduced likelihood of drug responsiveness. Significance: We found that Hispanic ethnicity is associated with a reduced likelihood of achieving seizure control and remission. This study suggests that factors associated with the race/ethnicity of patients contributes to their likelihood of achieving seizure freedom.

Abstract WMP91: Disparities in Inpatient Mortality from Acute Stroke: Near-national Estimates for Hispanics

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kori Sauser Zachrison ◽  
Mengyun Lin ◽  
Amresh Hanchate
Keyword(s):  
Acute Stroke ◽  
Patient Characteristics ◽  
National Sample ◽  
Inpatient Mortality ◽  
Discharge Data ◽  
Logistic Regression Models ◽  
Hispanic Patients ◽  
National Estimates ◽  
Race Ethnicity ◽  
Adjusted Model

Background: Hispanics are the largest minority in the US, yet there is little national data describing stroke outcomes among Hispanic patients. Objective: To measure inpatient mortality following admission for ischemic stroke (IS), hemorrhagic stroke (HS), and subarachnoid hemorrhage (SAH) among non-Hispanic blacks, non-Hispanic whites, and Hispanics. Methods: We combined discharge data (2010-11) from universe of admissions at all non-federal hospitals from 15 states that account for 85% of the Hispanic population and had near-complete reporting of race/ethnicity (AZ, CA, CO, FL, IL, MA, MD, NJ, NM, NV, NY, OR, PA, TX, VA). We identified all hospitalizations for IS, HS, and SAH, and estimated logistic and hospital-level hierarchical logistic regression models to obtain rates of inpatient mortality by race/ethnicity adjusted for patient characteristics (age, sex, race/ethnicity, comorbidities) and hospital characteristics (annual hospital stroke volume). Results: We found 567,498 discharges for acute stroke; Hispanics accounted for 11.7%, blacks for 15.6% and whites for 68.7%. Among all discharges, IS accounted for 83%, HS 12% and SAH 5%. Compared to whites, Hispanics and blacks were younger and had lower observed mortality rate for all stroke subtypes (IS: whites 5.2%, blacks 3.3%, Hispanics 4.3%, p<0.001; HS: whites 25.7%, blacks 20.8%, Hispanics 21.3%, p<0.001; and SAH: whites 20.2%, blacks 17.5%, Hispanics 19.3%, p<0.001). In the fully adjusted model, compared to whites, Hispanic inpatient mortality was lower for HS but nor for IS or SAH (Table); in contrast, blacks had lower inpatient mortality for IS and HS (Table). Individual states’ overall adjusted stroke mortality for all subgroups combined was not significantly different for Hispanics, with the exception of CA (OR 0.90, 95% CI 0.85-0.96). Conclusion: In a near-national sample, Hispanic patients had lower adjusted inpatient mortality rates than whites for HS, and similar rates for IS and SAH.

Heat-Etching with a Bullivant Type II Simple Freeze-Cleave Device

1970 ◽  
Vol 28 ◽  
pp. 106-107 ◽  
Author(s):  
Ronald S. Weinstein ◽  
N. Scott McNutt
Keyword(s):  
New Zealand ◽  
General Hospital ◽  
Massachusetts General Hospital ◽  
Type I ◽  
Type Ii ◽  
Collaborative Effort ◽  
Temperature And Pressure ◽  
The University

The Type I simple cold block device was described by Bullivant and Ames in 1966 and represented the product of the first successful effort to simplify the equipment required to do sophisticated freeze-cleave techniques. Bullivant, Weinstein and Someda described the Type II device which is a modification of the Type I device and was developed as a collaborative effort at the Massachusetts General Hospital and the University of Auckland, New Zealand. The modifications reduced specimen contamination and provided controlled specimen warming for heat-etching of fracture faces. We have now tested the Mass. General Hospital version of the Type II device (called the “Type II-MGH device”) on a wide variety of biological specimens and have established temperature and pressure curves for routine heat-etching with the device.

Evoking Issues of Race and Ethnicity in Research on Physiology and Interpersonal Communication

2020 ◽  
pp. 260-287
Author(s):  
Shardé M. Davis
Keyword(s):  
Interpersonal Communication ◽  
Race And Ethnicity ◽  
Communication Research ◽  
Interpersonal Interactions ◽  
The Past ◽  
Race Ethnicity ◽  
Diverse Groups ◽  
Future Work ◽  
Area Of Study

Investigating the role of physiology in communication research is a burgeoning area of study that has gained considerable attention by relational scholars in the past decade. Unfortunately, very few published studies on this topic have evoked important questions about the role of race and ethnicity. Exploring issues of ethnicity and race provides a more holistic and inclusive view of interpersonal communication across diverse groups and communities. This chapter addresses the gap in literature by considering the ways in which race and ethnicity matter in work on physiology and interpersonal interactions. More specifically, this chapter will first discuss the conceptual underpinnings of race, ethnicity, and other relevant concepts and then review extant research within and beyond the field of communication on race, ethnicity, interpersonal interactions, and physiology. These discussions set the foundation for this chapter to propose new lines of research that pointedly connect these four concepts and advance key principles that scholars should consider in future work.

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