Lowenstein, Daniel
Mayo Clinic
University of California, San Francisco
Citations 2
American Epilepsy Society/International League Against Epilepsy-North America Joint Task Force for Epilepsy Health Care Disparities in the United States
Kapur, Jaideep , Theodore, William, Clarke, Dave, Etienne, Mill, Gutierrez, Camilo , Jobst, Barbara C. , Johnson, Emily L. , Joshi, Sucheta, Kiriakopoulos, Elaine T. , Labiner, David M. , Lado, Fred A., Lowenstein, Daniel H. , Parko, Karen, Riker, Ellen, Poduri, Annapurna, Shellhaas, Renée A. , Sirven, Joseph I., Skjei, Karen, Stern, John M., Welty, Timothy E., Eickmeyer, Adam B., Strickland, Shawna L , Johnson, Emily L , Lekoubou, Alain , Lowenstein, Daniel , Shellhaas, Renée A , Strickland, Shawna L , Kapur, Jaideep , Jobst, Barbara , Theodore, William, Clarke, Dave, Etienne, Mill, Gutierrez, Camilo , Joshi, Sucheta, Kiriakopoulos, Elaine T. , Labiner, David M. , Lado, Fred A., Parko, Karen, Riker, Ellen, Poduri, Annapurna, Sirven, Joseph I., Skjei, Karen, Stern, John M., Welty, Timothy E.
Epilepsy Currents | June 9, 2025 | Volume: 26 | Issue: 2 | Pages: 99-107
Numerous factors including social determinants of health, knowledge gaps, economic challenges, workforce limitations, and health system deficiencies are associated with significant disparities in access to health care services and health outcomes for people with epilepsy (PWE). The American Epilepsy Society (AES) and the International League Against Epilepsy—North America (ILAE-NA) established a joint task force to explore and develop recommendations to address health care disparities experienced by PWE. The task force gathered foundational knowledge through meetings, public and patient organization comments and discussions to develop consensus recommendations. We enumerate the recommendations and discuss the rationale behind them to reduce disparities in epilepsy care through comprehensive research, inclusive clinical practices, robust advocacy, and targeted educational initiatives. While our recommendations are focused on the United States, we acknowledge that similar barriers and limitations exist for PWE globally and that these also need to be addressed within their local domains and with attention to unique factors therewithin.
Racial disparities in the utilization of invasive neuromodulation devices for the treatment of drug‐resistant focal epilepsy
Alcalá-Zermeño, Juan Luis , Fureman, Brandy , Grzeskowiak, Caitlin L. , Potnis, Ojas , Taveras, Maria, Logan, Margaret W. , Rybacki, Delanie, Friedman, Daniel , Lowenstein, Daniel H. , investigators, the HEP2, Lowenstein, Daniel , Kuzniecky, Ruben , French, Jacqueline , Grzeskowiak, Caitlin L , Taveras, Maria, French, Jacqueline A. , investigators, the HEP2
Epilepsia | March 20, 2024 | Volume: 65 | Issue: 5 | Pages: No page available
AbstractRacial disparities affect multiple dimensions of epilepsy care including epilepsy surgery. This study aims to further explore these disparities by determining the utilization of invasive neuromodulation devices according to race and ethnicity in a multicenter study of patients living with focal drug‐resistant epilepsy (DRE). We performed a post hoc analysis of the Human Epilepsy Project 2 (HEP2) data. HEP2 is a prospective study of patients living with focal DRE involving 10 sites distributed across the United States. There were no statistical differences in the racial distribution of the study population compared to the US population using census data except for patients reporting more than one race. Of 154 patients enrolled in HEP2, 55 (36%) underwent invasive neuromodulation for DRE management at some point in the course of their epilepsy. Of those, 36 (71%) were patients who identified as White. Patients were significantly less likely to have a device if they identified solely as Black/African American than if they did not (odds ratio = .21, 95% confidence interval = .05–.96, p = .03). Invasive neuromodulation for management of DRE is underutilized in the Black/African American population, indicating a new facet of racial disparities in epilepsy care.