MP80-20 RACIAL DISPARITIES IN AXIAL IMAGING UTILIZATION ACROSS THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATIVE (PURC) (2019)

You have accessJournal of UrologyImaging/Radiology: Uroradiology III (MP80)1 Apr 2019MP80-20 RACIAL DISPARITIES IN AXIAL IMAGING UTILIZATION ACROSS THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATIVE (PURC) Andrew Higgins*, Jiangtao Gou, Laura McGarry, Bret Marlowe, Claudette Fonshell, Edouard Trabulsi, Mark Mann, David Chen, John Danella, Thomas Guzzo, Thomas Lanchoney, Jay Raman, Adam Reese, Jeffrey Tomaszewski, Marc Smaldone, Robert Uzzo, and Serge Ginzburg Andrew Higgins*Andrew Higgins* More articles by this author , Jiangtao GouJiangtao Gou More articles by this author , Laura McGarryLaura McGarry More articles by this author , Bret MarloweBret Marlowe More articles by this author , Claudette FonshellClaudette Fonshell More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Mark MannMark Mann More articles by this author , David ChenDavid Chen More articles by this author , John DanellaJohn Danella More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Thomas LanchoneyThomas Lanchoney More articles by this author , Jay RamanJay Raman More articles by this author , Adam ReeseAdam Reese More articles by this author , Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Robert UzzoRobert Uzzo More articles by this author , and Serge GinzburgSerge Ginzburg More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557419.34464.b9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: CT and MRI are acceptable imaging modalities in diagnosis and staging of prostate cancer (CaP). We examine axial imaging utilization patterns across a large regional collaborative, with a focus on racial disparity in MRI utilization. METHODS: PURC is a prospective regional collaborative comprised of nine large academic and private urology practices in Southeastern PA and NJ, launched in 2015. Demographic and clinicopathologic data for men with clinically localized CaP were abstracted and axial imaging modality (CT vs. MRI) was evaluated. Fisher's exact t-test, ANOVA, Wilcoxon rank sum test and logistic regression models were utilized for univariable and multivariable analyses, respectively. RESULTS: Between January 2015 and May 2018, 6109 eligible patients were enrolled in PURC. Patients with clinically localized CaP that underwent axial imaging and had sufficient information were included, resulting in 1376 men in the cohort of interest. Demographic and clinicopathologic characteristic of the cohort are described in Table. Overall, MRI was found to be a more common imaging modality than CT (68.6% vs 31.4%). Caucasian men were more likely to undergo MRI than African-American (AA) men (72.1% vs 57.0%, p<0.001) on univariable analysis. Caucasian race (OR 1.87, 95% CI 1.30-2.69, p<0.001) was a strong independent predictor of MRI utilization on multivariable analysis, along with younger age (p=0.008), lower PSA value (p=0.009), lower Gleason score (p<0.001) and treatment at a practice with higher patient throughput (p<0.001). Significant variation was observed across individual practice sites (Figure). CONCLUSIONS: Significant racial disparity in axial imaging utilization exists across PURC, with lower rates of MRI utilization in AA men. Variation in the utilization and in the degree of this disparity was observed across individual practices. More granular data is needed to better understand underlying causes of such disparity. Source of Funding: Data was provided with permission from the Pennsylvania Urologic Regional Collaborative (PURC), funded by participating urology practices and the Partnership for Patient Care, a quality improvement initiative supported by the Health Care Improvement Foundation, Independence Blue Cross, and Southeastern PA hospitals and health systems. Philadelphia, PA; Danville, PA; Philadelphia, PA; Bryn Mawr, PA; Hershey, PA; Philadelphia, PA; Camden, NJ; Philadelphia, PA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1170-e1170 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Higgins* More articles by this author Jiangtao Gou More articles by this author Laura McGarry More articles by this author Bret Marlowe More articles by this author Claudette Fonshell More articles by this author Edouard Trabulsi More articles by this author Mark Mann More articles by this author David Chen More articles by this author John Danella More articles by this author Thomas Guzzo More articles by this author Thomas Lanchoney More articles by this author Jay Raman More articles by this author Adam Reese More articles by this author Jeffrey Tomaszewski More articles by this author Marc Smaldone More articles by this author Robert Uzzo More articles by this author Serge Ginzburg More articles by this author Expand All Advertisement PDF downloadLoading ...