title: Racial differences in patient expectations prior to resective epilepsy surgery.
abstract: We assessed the nature and frequency of preoperative expectations among patients with refractory epilepsy who were enrolled in a seven-center observational study of epilepsy surgery outcomes. At enrollment, patients responded to open-ended questions about expectations for surgical outcome. With the use of an iterative cutting-and-sorting technique, expectation themes were identified and rank-ordered. Associations of expectations with race/ethnicity were evaluated. Among 391 respondents, the two most frequently endorsed expectations (any rank order) were driving (62%) and job/school (43%). When only the most important (first-ranked) expectation was analyzed, driving (53%) and cognition (17%) were most frequently offered. Nonwhites endorsed job/school and cognition more frequently and driving less frequently than whites (all P0.05), whether expectations of any order or only first-ranked expectations were included. Elucidating the reason for these differences can aid in the clinical decision-making process for resective surgery and potentially address disparities in its utilization.
authors.affiliation: Department of Neurology, University of California at Los Angeles, 911 Broxton Avenue, Los Angeles, CA 90024, USA. cbower@mednet.ucla.edu
authors.forename: Christine Bower
authors.initials: CB
authors.lastname: Baca
authors.forename: Eric M
authors.initials: EM
authors.lastname: Cheng
authors.forename: Susan S
authors.initials: SS
authors.lastname: Spencer
authors.forename: Stefanie
authors.initials: S
authors.lastname: Vassar
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Vickrey
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001334:Automobile Driving; D003071:Cognition / Q000502:physiology; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D004651:Employment; D004827:Epilepsy / Q000453:epidemiology* / Q000601:surgery*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000523:psychology* / Q000706:statistics & numerical data*; D011788:Quality of Life; D012574:Schools; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult