Disparities in the treatment of primary hyperparathyroidism: A scoping review and conceptual model

Alexander S Chiu; Markayle Schears; Mary Hitchcock; Rebecca Sippel; Amy Kind

doi:10.1016/j.amjsurg.2024.04.010

Disparities in the treatment of primary hyperparathyroidism: A scoping review and conceptual model

Am J Surg. 2024 Apr 16:S0002-9610(24)00227-7. doi: 10.1016/j.amjsurg.2024.04.010. Online ahead of print.

Authors

Alexander S Chiu¹, Markayle Schears², Mary Hitchcock³, Rebecca Sippel⁴, Amy Kind⁵

Affiliations

¹ Section of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: Chiu@Surgery.Wisc.edu.
² University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
³ Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, WI, USA.
⁴ Section of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
⁵ Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

PMID: 38653710
DOI: 10.1016/j.amjsurg.2024.04.010

Abstract

Background: Primary hyperparathyroidism is underdiagnosed and surgical treatment is underutilized and inequitably distributed. We present a review of the current literature on disparities in the treatment of hyperparathyroidism, with a focus on gaps in knowledge and paths forward.

Methods: We searched PubMed and Scopus for abstracts related to disparities in hyperparathyroidism.

Results: 16 articles (of 1541) met inclusion criteria. The most commonly examined disparity was race. Notably, Black, Hispanic, and Asian patients were less likely to undergo surgery after diagnosis, face delays in obtaining treatment, and less likely to see a high-volume surgeon. Similar disparities in care were noted among those without insurance, older patients, and patients with limited English proficiency.

Conclusion: There are clear inequities in the treatment of hyperparathyroidism. Current research is in an early "identification" phase of disparities research; a new conceptual model based on established socioecological frameworks is provided to help move the field forward to "understanding" and "intervening" in surgical disparities.

Keywords: Conceptual model; Health disparities; Hyperparathyroidism; Parathyroidectomy.

Publication types

Review