{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:09:18Z","timestamp":1790352558189,"version":"4.1.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Our primary objective was to evaluate if disparities in race, sex, age, and socioeconomic status (SES) exist in utilization of advanced neuroimaging in year 2015 in a population-based study. Our secondary objective was to identify the disparity trends and overall imaging utilization as compared with years 2005 and 2010.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This was a retrospective, population-based study that utilized the GCNKSS (Greater Cincinnati\/Northern Kentucky Stroke Study) data. Patients with stroke and transient ischemic attack were identified in the years 2005, 2010, and 2015 in a metropolitan population of 1.3 million. The proportion of imaging use within 2 days of stroke\/transient ischemic attack onset or hospital admission date was computed. SES determined by the percentage below the poverty level within a given respondent\u2019s US census tract of residence was dichotomized. Multivariable logistic regression was used to determine the odds of advanced neuroimaging use (computed tomography angiogram\/magnetic resonance imaging\/magnetic resonance angiogram) for age, race, gender, and SES.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              There was a total of 10\u2009526 stroke\/transient ischemic attack events in the combined study year periods of 2005, 2010, and 2015. The utilization of advanced imaging progressively increased (48% in 2005, 63% in 2010, and 75% in 2015 [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001]). In the combined study year multivariable model, advanced imaging was associated with age and SES. Younger patients (\u226455 years) were more likely to have advanced imaging compared with older patients (adjusted odds ratio, 1.85 [95% CI, 1.62\u20132.12];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), and low SES patients were less likely to have advanced imaging compared with high SES (adjusted odds ratio, 0.83 [95% CI, 0.75\u20130.93];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). A significant interaction was found between age and race. Stratified by age, the adjusted odds of advanced imaging were higher for Black patients compared with White patients among older patients (&gt;55 years; adjusted odds ratio, 1.34 [95% CI, 1.15\u20131.57];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), but no racial differences among the young.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Racial, age, and SES-related disparities exist in the utilization of advanced neuroimaging for patients with acute stroke. There was no evidence of a change in trend of these disparities between the study periods.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.122.040790","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T18:00:50Z","timestamp":1679940050000},"page":"1001-1008","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Trends in Disparities in Advanced Neuroimaging Utilization in Acute Stroke: A Population-Based Study"],"prefix":"10.1161","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6428-6499","authenticated-orcid":true,"given":"Achala","family":"Vagal","sequence":"first","affiliation":[{"name":"Department of Radiology (A.V., L.W., C.S.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3933-1574","authenticated-orcid":true,"given":"Heidi","family":"Sucharew","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (H.S.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5107-438X","authenticated-orcid":true,"given":"Lily L.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology (A.V., L.W., C.S.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9773-4013","authenticated-orcid":true,"given":"Brett","family":"Kissela","sequence":"additional","affiliation":[{"name":"Department of Neurology (B.K., K.A., M.H., D.W., S.F., E.M., S.D., K.W., P.K.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1620-4721","authenticated-orcid":true,"given":"Kathleen","family":"Alwell","sequence":"additional","affiliation":[{"name":"Department of Neurology (B.K., K.A., M.H., D.W., S.F., E.M., S.D., K.W., P.K.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1017-1036","authenticated-orcid":true,"given":"Mary","family":"Haverbusch","sequence":"additional","affiliation":[{"name":"Department of Neurology (B.K., K.A., M.H., D.W., S.F., E.M., S.D., K.W., P.K.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2466-7155","authenticated-orcid":true,"given":"Daniel","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Neurology (B.K., K.A., M.H., D.W., S.F., E.M., S.D., K.W., P.K.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6534-3029","authenticated-orcid":true,"given":"Simona","family":"Ferioli","sequence":"additional","affiliation":[{"name":"Department of Neurology (B.K., K.A., M.H., D.W., S.F., E.M., S.D., K.W., P.K.), University of Cincinnati Medical Center, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6867-8630","authenticated-orcid":true,"given":"Jason","family":"Mackey","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis (J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4465-9280","authenticated-orcid":true,"given":"Felipe","family":"De Los Rios La Rosa","sequence":"additional","affiliation":[{"name":"Baptist Health Miami Neuroscience Institute, FL 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