TY - JOUR
T1 - Racial variation in treatment preferences and willingness to randomize in the Spine Patient Outcomes Research Trial (SPORT)
AU - Arega, Addisalem
AU - Birkmeyer, Nancy J.O.
AU - Lurie, Jon D.N.
AU - Tosteson, Tor
AU - Gibson, Jennifer
AU - Taylor, Brett A.
AU - Morgan, Tamara Shawver
AU - Weinstein, James Neil
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/9
Y1 - 2006/9
N2 - STUDY DESIGN. Analysis of baseline data for patients enrolled in Spine Patient Outcomes Research Trial (SPORT), a project conducting three randomized and three observational cohort studies of surgical and nonoperative treatments for intervertebral disc herniation (IDH), spinal stenosis (SpS), and degenerative spondylolisthesis (DS). OBJECTIVE. To explore racial variation in treatment preferences and willingness to be randomized. SUMMARY OF BACKGROUND DATA. Increasing minority participation in research has been a priority at the NIH. Prior studies have documented lower rates of participation in research and preferences for invasive treatment among African-Americans. METHODS. Patients enrolled in SPORT (March 2000 to February 2005) that reported data on their race (n = 2,323) were classified as White (87%), Black (8%), or Other (5%). Treatment preferences (nonoperative, unsure, surgical), and willingness to be randomized were compared among these groups while controlling for baseline differences using multivariate logistic regression. RESULTS. There were numerous significant differences in baseline characteristics among the racial groups. Following adjustment for these differences, Blacks remained less likely to prefer surgical treatment among both IDH (White, 55%; Black, 37%; Other, 55%, P = 0.023) and SpS/DS (White, 46%; Black, 30%; Other, 43%; P = 0.017) patients. Higher randomization rates among Black IDH patients (46% vs. 30%) were no longer significant following adjustment (odds ratio [OR] = 1.45, P = 0.235). Treatment preference remained a strong independent predictor of randomization in multivariate analyses for both IDH (unsure OR = 3.88, P < 0.001 and surgical OR = 0.23, P < 0.001) and SpS/DS (unsure OR = 6.93, P < 0.001 and surgical OR = 0.45, P < 0.001) patients. CONCLUSIONS. Similar to prior studies, Black participants were less likely than Whites or Others to prefer surgical treatment; however, they were no less likely to agree to be randomized. Treatment preferences were strongly related to both race and willingness to be randomized.
AB - STUDY DESIGN. Analysis of baseline data for patients enrolled in Spine Patient Outcomes Research Trial (SPORT), a project conducting three randomized and three observational cohort studies of surgical and nonoperative treatments for intervertebral disc herniation (IDH), spinal stenosis (SpS), and degenerative spondylolisthesis (DS). OBJECTIVE. To explore racial variation in treatment preferences and willingness to be randomized. SUMMARY OF BACKGROUND DATA. Increasing minority participation in research has been a priority at the NIH. Prior studies have documented lower rates of participation in research and preferences for invasive treatment among African-Americans. METHODS. Patients enrolled in SPORT (March 2000 to February 2005) that reported data on their race (n = 2,323) were classified as White (87%), Black (8%), or Other (5%). Treatment preferences (nonoperative, unsure, surgical), and willingness to be randomized were compared among these groups while controlling for baseline differences using multivariate logistic regression. RESULTS. There were numerous significant differences in baseline characteristics among the racial groups. Following adjustment for these differences, Blacks remained less likely to prefer surgical treatment among both IDH (White, 55%; Black, 37%; Other, 55%, P = 0.023) and SpS/DS (White, 46%; Black, 30%; Other, 43%; P = 0.017) patients. Higher randomization rates among Black IDH patients (46% vs. 30%) were no longer significant following adjustment (odds ratio [OR] = 1.45, P = 0.235). Treatment preference remained a strong independent predictor of randomization in multivariate analyses for both IDH (unsure OR = 3.88, P < 0.001 and surgical OR = 0.23, P < 0.001) and SpS/DS (unsure OR = 6.93, P < 0.001 and surgical OR = 0.45, P < 0.001) patients. CONCLUSIONS. Similar to prior studies, Black participants were less likely than Whites or Others to prefer surgical treatment; however, they were no less likely to agree to be randomized. Treatment preferences were strongly related to both race and willingness to be randomized.
KW - Clinical trial
KW - Degenerative spondylolisthesis
KW - Intervertebral disc herniation
KW - Racial variation
KW - Spinal stenosis
KW - Surgical treatment
KW - Treatment preference
KW - Willingness to be randomized
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U2 - 10.1097/01.brs.0000232708.66608.ac
DO - 10.1097/01.brs.0000232708.66608.ac
M3 - Article
C2 - 16946665
AN - SCOPUS:33748342331
VL - 31
SP - 2263
EP - 2269
JO - Spine
JF - Spine
SN - 0362-2436
IS - 19
ER -