Evaluation for Potential Inequities in Efficacy and Patient Outcomes Following Implementation of a STAT Outpatient Neuroimaging Pathway for Evaluation of Patients with Optic Disc Swelling

Previously, our group piloted an outpatient STAT neuroimaging pathway for optic disc swelling patients, typically referred to the emergency department (ED) for urgent neuroimaging. The STAT pathway is an alternative facilitating urgent outpatient MRIs, avoiding significant ED wait times and costs without compromising clinical outcomes. This study assesses demographic and BMI-based inequities in STAT pathway efficacy and clinical outcomes.
A retrospective chart review identified patients receiving STAT outpatient or ED-based neuroimaging for optic disc swelling between 2020 and 2024. Data were collected on demographics and clinical characteristics at presentation and latest follow-up and STAT MRI scheduling/completion. Univariate and bivariate analyses evaluated for demographic-based outcome differences among STAT patients and compared demographic characteristics of STAT and ED patients. Multivariate regressions examined predictors of changes in ophthalmologic measures over time.
We examined 50 STAT and 63 ED patients. Among STAT patients, females were relatively younger with higher BMIs, baseline VF MDs, and baseline RNFL thickness (p < .05 for all). Blacks were younger than whites (p < .01). There were no significant demographic or BMI-based differences in clinical outcomes or MRI scheduling/completion rates among STAT patients. Multivariate models revealed no significant predictors of changes in ophthalmologic measures over time for STAT patients. The STAT and ED cohorts had similar demographic profiles.
Overall, there were no demographic variations in outcomes or MRI scheduling/completion rates or differences in the demographic composition between the STAT and ED cohorts. These findings support the STAT protocol as an equitable alternative to ED-based care for a subgroup of patients with optic disc swelling.