{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:15:52Z","timestamp":1791825352189,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Given the importance of early diagnosis and treatment of myasthenia gravis (MG), it is critical to understand disparities in MG care. We aimed to determine if there are any differences in testing, treatment, and\/or access to neurologists for patients of varying sex and race\/ethnicity with MG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a nationally representative healthcare claims database of privately insured individuals (2001\u20132018) to identify incident cases of MG using a validated definition. Diagnostic testing, steroid\u2010sparing agents, intravenous immunoglobulin (IVIG), plasma exchange (PLEX), and thymectomy were defined using drug names or CPT codes. Steroid use was defined using AHFS class codes. We also determined whether an individual had a visit to a neurologist and the time between primary care and neurologist visits. Logistic regression determined associations between sex and race\/ethnicity and testing, treatments, and access to neurologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Female patients were less likely to get a computed tomography (CT) chest (odds ratio (OR) 0.73, 95% confidence interval (CI): 0.64\u20130.83), receive steroids (OR: 0.85, 95% CI: 0.75\u20130.97), steroid\u2010sparing agents (OR: 0.84, 95% CI: 0.72\u20130.97), and IVIG or PLEX (OR: 0.80, 95% CI: 0.67\u20130.95). Black patients were less likely to receive steroids (OR: 0.78, 95% CI: 0.63\u20130.96). No significant disparities were seen in access to neurologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We found healthcare disparities in MG treatment with female and Black patients receiving less treatment than men and those of other races\/ethnicities. Further research and detailed assessments accounting for individual patient factors are needed to confirm these apparent disparities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28215","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T11:39:56Z","timestamp":1722253196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Possible sex and racial disparities in myasthenia gravis care"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4838-4783","authenticated-orcid":false,"given":"Shriya","family":"Suresh","sequence":"first","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0138-8436","authenticated-orcid":false,"given":"Evan L.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000322497"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12057"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000004025"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000306411.46934.ef"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e3182213e24"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318203e952"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000236053.37695.15"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013059"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000176054.72325.0f"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.106.478495"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000375463"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000002790"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102377\u201010\u201046"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(15)00145\u20103"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112235"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181a41211"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27120"},{"issue":"2","key":"e_1_2_11_19_1","first-page":"255","article-title":"Clinical characteristics of refractory myasthenia gravis patients","volume":"86","author":"Suh J","year":"2013","journal-title":"Yale J Biol Med"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/cnd.0000000000000257"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26114"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2011.10.003"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26104"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010015\u20100298\u20101"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010018\u20108995\u20104"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27331"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.31138\/mjr.32.2.164"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/nxi.0000000000000507"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6358624"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101497.2001.00229.x"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21191"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2007.07.002"},{"key":"e_1_2_11_33_1","unstructured":"QiC AndersonA GelinasD et al.Racial disparities in acute care utilization outcomes among those with myasthenia gravis. 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