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The initially reported periprocedural neurological events rates associated with transcatheter aortic valve replacement raised concerns that ultimately led to the development and to the clinical research of novel embolic protection devices. Although the reduction of clinical stroke is a desired goal, the current research design of embolic protection devices focuses on surrogate markers of the clinical disease, primarily on silent central nervous system lesions observed in postprocedural diffuse-weighted magnetic resonance imaging and cognitive function testing. As the mere presence of particulate debris in brain matter may not correlate with the extent of brain injury, cognitive function, or quality of life, the clinical significance of embolic protection devices has yet to be determined, and interpretation of study results with regard to real-life clinical use should be viewed accordingly. The purpose of this article is to provide an overview of the updated ongoing clinical research on embolic protection devices and present its major caveats. [ABSTRACT FROM AUTHOR]

Accurate and complete racial/ethnic data in the electronic health record are a requisite step to addressing disparities in neurologic care, and at local, regional, and national levels. The current data pertaining to the patients' race and ethnicity contained in the electronic health record are inadequate. This article outlines recommendations at the individual practice and electronic health record vendor level to improve documentation of race and ethnicity., Competing Interests: A.L. Weathers has received personal compensation in the range of $500–$4,999 for serving as an Editor or Associate Editor or Editorial Advisory Board Member for American Academy of Neurology; has received personal compensation in the range of $500–$4,999 for serving as a CME question writer, interviewer, and presenter with American Academy of Neurology; has a noncompensated relationship as a Chair on the Neurology Adult Steering Board with Epic that is relevant to AAN interests or activities; and serves as a voluntary member of the AAN Registry Subcommittee and as a voluntary vice-chair of the Quality Informatics Subcommittee. N. Garg reports no disclosures relevant to the manuscript, and serves as a voluntary member of the AAN Registry Subcommittee. K.B. Lundgren reports no disclosures relevant to the manuscript, and is an employee of the American Academy of Neurology. S.M. Benish reports no disclosures relevant to the manuscript, and serves as a voluntary Chair of the AAN Registry Subcommittee and a Member of the AAN Quality Committee and on the AAN Board of Directors. C.B. Baca reports no disclosures relevant to the manuscript, and serves as a voluntary member of the AAN Quality Committee and a voluntary member of the AAN Registry Subcommittee. R.T. Benson has received personal compensation in the range of $100,000–$499,000 for serving as a federal employee with HHS/NIH, and serves as a voluntary member of the AAN Registry Subcommittee. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp., (© 2024 American Academy of Neurology.)

Background and Objectives: The primary objective is to examine potential racial and ethnic (R/E) disparities in ambulatory neurology quality measures within the American Academy of Neurology Axon Registry. R/E disparities in neurologic US morbidity and mortality have been clearly documented. Despite these findings, there have been no nationwide examinations of how ambulatory neurologic care affects these negative health outcomes., Methods: This was a retrospective nonrandomized cohort study of patients in the AAN Axon Registry. The Axon Registry is a neurology-specific outpatient quality registry that collects, reports, and analyzes real-world deidentified electronic health record (EHR) data. Patients were included in the study if they contributed toward one of the selected quality measures for multiple sclerosis, epilepsy, Parkinson disease, or headache during the study period of January 1, 2019-December 31, 2019. Descriptive analyses of patient demographics were performed and then stratified by race and ethnicity., Results: There were a total of 633,672 patients included in these analyses. Separate analyses were performed for race (64% White, 8% Black, 1% Asian, and 27% unknown) and ethnicity (52% not Hispanic, 5% Hispanic, and 43% unknown). The mean age ranged from 18 to 55 years, with 61% female and 39% male. Quality measures were chosen based on completeness of R/E data and were either process or outcomes focused. Statistically significant differences were noted after controlling for multiple comparisons., Discussion: The large proportion of missing or unknown R/E data and low overall rate of performance on these quality measures made the relevance of small differences difficult to determine. This analysis demonstrates the feasibility of using the Axon Registry to assess neurologic disparities in outpatient care. More education and training are required on the accurate capture of R/E data in the EHR., Competing Interests: R.T. Benson serves as a voluntary member of the AAN Registry Subcommittee and has nothing to disclose. The views expressed are the authors' own and do not necessarily reflect those of the National Institutes of Health, the Department of Health and Human Services, or the United States Government. S.M. Benish serves as voluntary Chair of the AAN Registry Subcommittee and Member of the AAN Quality Committee and on the AAN Board of Directors and has nothing to disclose. G.J. Esper has received personal compensation in the range of $500–$4,999 for serving as a consultant for NeuroOne Technology Corporation, has received personal compensation in the range of $500–$4,999 for serving as a consultant for Pfizer, has received personal compensation in the range of $500–$4,999 for serving as an Expert Witness for Mitchell Law Group, and reports no other disclosures that are relevant to this manuscript. The institution of B.M. Kissela has received research support from the NIH/NINDS and NCATS. B.M. Kissela reports no other disclosures that are relevant to this manuscript. N. Rosendale has received personal compensation in the range of $500–$4,999 for serving as an Editor Associate Editor or Editorial Advisory Board Member for Neurology. The institution of N. Rosendale has received research support from the UCSF Academy of Medical Educators. N. Rosendale reports no other disclosures that are relevant to this manuscript. E.T. Marulanda-Londono and O.A. Hope have nothing to disclose. T.T.A. Pham is a member of the AAN Registry Subcommittee. T.T.A. Pham has nothing to disclose. M. Roe, A. Torres, A. Lien, and S. Kauwe are employees of Verana Health and have nothing to disclose. K.B. Lundgren and A. Mante are employees of the American Academy and have nothing to disclose. B. Schierman is an employee of the American Academy and has nothing to disclose. L.K. Jones has received publishing royalties from a publication relating to health care and serves as a voluntary member of the Board of Directors with the Mayo Clinic ACO and American Academy of Neurology Institute. L.K. Jones reports no other disclosures that are relevant to this manuscript. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp., (© 2023 American Academy of Neurology.)