ABSTRACT
Introduction: Racial disparities continue to exist during the COVID-19 pandemic. A systematic review found that Black and Hispanic patients experience disproportionate COVID-19 hospitalizations and higher morbidity and mortality. Low level evidence in that review suggested that Asians' outcomes are similar to those of non-Hispanic whites. As most practicing gastroenterologists are White, and as endoscopies are aerosolizing procedures risking viral transmission, this study evaluates differences in fear levels among gastroenterologists from different racial backgrounds. Methods: This IRB-approved multi-center cross-sectional study used a snowball sampling approach to disseminate a 42-question survey, pilot-tested for reliability and validity, to gastroenterologists across different geographic locations in the US. Fear levels during endoscopic procedures on suspected/confirmed COVID-19 patients were assessed using a 1-10 Likert scale, with 10 being the greatest fear. Fear was assessed at three points for upper and lower endoscopies: first procedure, subsequent before the COVID-19 vaccine, and subsequent after the vaccine. Data was analyzed using Pearson's chi-squared, Mann-Whitney U, and Wilcoxon rank tests and significance was determined at p<0.05 Results: We analyzed 69 responses from gastroenterologists at 30 sites. Of the respondents, 39 selfidentified as white, 3 as Black, 6 as Latinx, 4 as Middle Eastern, and 17 as Asian. Due to the small sample size, non-White racial groups were combined to evaluate the impact of race on reported fear level reported by gastroenterologists who performed endoscopies during the COVID-19 pandemic. Fear levels at the six assessed points were not significantly different when comparing Asians to Whites, and when comparing Blacks and Latinx to Whites. However, Asians, Blacks, and Latinx had a higher fear level post vaccine when performing lower endoscopies compared to Whites (mean (m) 53.59, standard deviation (SD)=2.83 vs m=1.94, SD=1.083, respectively;P=0.045). Conclusion: While results can be due to chance due to the small sample size and survey response bias, our study suggests that after receiving the COVID-19 vaccine, minority endoscopists experienced greater fear than White endoscopists while performing lower endoscopies. It is possible that the disproportionate COVID-19 disease burden in Black and Hispanic communities negates the decrease in fear levels that was experienced by White endoscopists even after receiving the COVID-19 vaccine..
ABSTRACT
Purpose: With the rise of the COVID-19 pandemic, interventional radiology (IR) clinics nationwide have adopted a virtual healthcare delivery model. The purpose of this study was to gauge the success of virtual visits at an outpatient interventional radiology practice in Washington, DC and compare the demographics and types of conditions seen before and after the transition to telemedicine. Materials and Methods: In this IRB-approved retrospective study, appointments scheduled with interventional radiology at an academic tertiary care institution between April 1st, 2019 and July 15th, 2019 were compared with appointments scheduled during the same time frame in 2020. All appointments scheduled in 2019 were in-office visits while all appointments scheduled in 2020 were telemedicine visits. Charts were reviewed for sociodemographic characteristics, types of visits, diagnoses, comorbidities, and scheduled procedures. Descriptive statistics and Pearson’s chi-squared tests were used to compare appointments scheduled in 2019 and 2020. Results: Of 180 appointments, 66.6% (n = 100) were scheduled in 2019 and 44.4% (n = 80) were scheduled in 2020. There was no difference in age, age ranges, gender, race distribution, or insurance status between both groups. While a greater percentage of patients presented for oncology-related problems in 2020 than in 2019, the overall difference in presenting problems was not significant (P = 0.13). The percentage of follow-up patients rose from 44.0% in 2019 to 56.3% in 2020 (P = 0.10). Of all telemedicine encounters, 91.3% demonstrated success of establishing a two-way secure audio and video connection with patients. Conclusions: This interventional radiology department cared for similar demographics of patients and case types via telemedicine visits when compared to clinic visits of the same time frame in 2019. While limited by the small sample size, these results indicate that outpatient interventional radiology practices are amenable to transitioning to online-only visits with improved ability to perform longer term follow up.