{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T09:08:25Z","timestamp":1768554505614,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R37CA246565"],"award-info":[{"award-number":["R37CA246565"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K23AG083125"],"award-info":[{"award-number":["K23AG083125"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG028741"],"award-info":[{"award-number":["P30AG028741"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG065726"],"award-info":[{"award-number":["R33AG065726"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although racial disparities in end\u2010of\u2010life care exist, whether the effect of specialist palliative care (PC) on end\u2010of\u2010life outcomes differs by race is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We created a propensity\u2010matched cohort of Black and non\u2010Hispanic White (NHW) older adults with metastatic cancer who did and did not receive specialist PC in the last 6\u2009months of life. End\u2010of\u2010life outcomes included hospice use, hospice enrollment \u2265\u20093\u2009days, intensive care unit (ICU) use in the last 30\u2009days of life, and use of chemotherapy in the last 14\u2009days of life. We used Cox regression models to evaluate for the presence of interaction between specialist PC and race for all outcomes on the multiplicative scale using interaction terms, and on the additive scale using the relative risk due to interaction (RERI), attributable proportion (AP) and synergy index (SI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 1:1 matching, 13,931 exposed and 13,931 unexposed older adults were included, of which 13.4% were Black. In comparison to those who did not receive specialist PC, both Black and NHW older adults who received specialist PC were more likely to use hospice (71.0% versus 52.4% for Black,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001; 80.4% versus 63.2% for NHW,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), have hospice enrollment \u2265\u20093\u2009days (65.5% versus 44.0% for Black,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001; 74.2% versus 52.6% for NHW,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), and have less use of the ICU (16.4% versus 19.9% for Black,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0058; 11.3% versus 14.0% for NHW,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) or chemotherapy at the end\u2010of\u2010life (1.2% versus 2.4% for Black,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0075, 1.4% versus 3.4% for NHW,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). There was no evidence of multiplicative interaction or additive interaction for any outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In older adults with metastatic cancer, there was no evidence for heterogeneity of effect for specialist PC between Black and NHW patients, suggesting that differences in the efficacy of specialist PC are not responsible for racial disparities in end\u2010of\u2010life care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19587","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T02:09:48Z","timestamp":1750903788000},"page":"3190-3195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Heterogeneity of Effect of Specialist Palliative Care for Black and Non\u2010Hispanic White Older Adults With Metastatic Cancer"],"prefix":"10.1111","volume":"73","author":[{"given":"Ling","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Anesthesiology College of Physicians and Surgeons, Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2659-8795","authenticated-orcid":false,"given":"Komal P.","family":"Murali","sequence":"additional","affiliation":[{"name":"NYU Rory Meyers College of Nursing  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Sean","family":"Morrison","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai and James J Peters VA  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2022.09.010"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010019\u201005142\u2010z"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2016.10.001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01045"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.09.017"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.6458"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP.23.00420"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/10499091241256627"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120922779"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049909118809975"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.01.029"},{"key":"e_1_2_10_14_1","unstructured":"National Palliative Care Registry \u201cGraphs of Hospital Findings: Palliative Care Program Features \u201d2017 https:\/\/registry.capc.org\/metrics\u2010resources\/summary\u2010data\/."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glz224"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.9468"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.14639"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001216"},{"key":"e_1_2_10_19_1","unstructured":"\u201cPPS\u2010Exempt Cancer Hospital Quality Reporting (PCHQR) Program Measures \u201dhttps:\/\/qualitynet.cms.gov\/pch\/pchqr\/measures."},{"key":"e_1_2_10_20_1","unstructured":"\u201cAmerican Society of Clinical Oncology Quality Measures Library \u201dhttps:\/\/old\u2010prod.asco.org\/practice\u2010patients\/quality\u2010measures\/measures\u2010library\/national\u2010quality\u2010forum."},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654\u2010011\u20109554\u20109"},{"issue":"6","key":"e_1_2_10_22_1","first-page":"655","article-title":"A SAS Program Calculating Three Measures of Interaction With Confidence Intervals","volume":"7","author":"Lundberg M.","year":"1996","journal-title":"Epidemiology"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2006.10.009"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2022.0237"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.322"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524\u2010016\u20100054\u20109"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.19587","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T11:33:20Z","timestamp":1764416000000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.19587"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/jgs.19587"],"URL":"https:\/\/doi.org\/10.1111\/jgs.19587","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,25]]},"assertion":[{"value":"2025-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}