In Reply We thank DiLuca et al for calling attention to a key limitation of our trial and the need for future trials to address diversity. We think it is important to point out that this issue is much larger than any individual study and also more complex than race/ethnicity. Race/ethnicity, class, education, and other socioeconomic factors drive disparities in palliative care and are associated with access to specialist care, use of therapeutics, and outcomes in Parkinson disease (PD).1,2 While we could simply blame the lack of diversity in our study on larger societal factors, there are lessons that can be learned from our trial that may inform future work.
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Kluger BM, Pantilat S, Miyasaki J. Palliative Care in Parkinson Disease—Is It Beneficial for All?—Reply. JAMA Neurol. 2020;77(11):1450–1451. doi:10.1001/jamaneurol.2020.3215
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