ArticlePloS one2013
Surgery or consultation: a population-based cohort study of use of orthopaedic surgeon services.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Identifying the Surgical to Nonsurgical Care Transition for Trauma Patients: Time to Redesign Trauma Workflow.The American surgeon · 2026Article
- Disparity in access to orthopedic surgery between public and private healthcare insurance: a nationwide population-based study.BMC musculoskeletal disorders · 2025Article
- Patient-Reported Experiences of Musculoskeletal Virtual Care Delivered by Advanced Practice Physiotherapists.Physiotherapy Canada. Physiotherapie Canada · 2024Article
- Clinician's Commentary on Bødskov et al.Physiotherapy Canada. Physiotherapie Canada · 2022Article
- Inter-professional agreement and collaboration between extended scope physiotherapists and orthopaedic surgeons in an orthopaedic outpatient shoulder clinic - a mixed methods study.BMC musculoskeletal disorders · 2021Article
- A comparison of one-year treatment utilization for shoulder osteoarthritis patients initiating care with non-orthopaedic physicians and orthopaedic specialists.BMC musculoskeletal disorders · 2018Article
- Utilizing the physician assistant role: case study in an upper-extremity orthopedic surgical program.Canadian journal of surgery. Journal canadien de chirurgie · 2017Article
- Musculoskeletal care pathways for adults with hip and knee pain at the interface between primary and secondary care: protocol for a systematic review.Systematic reviews · 2016Article
- Surgical assessment: measuring unobserved health.BMC surgery · 2015Observational
- Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThis population-based cohort study has the objective to understand the sociodemographic characteristics and health conditions of patients who do not receive surgery within 18 months following an ambulatory visit to an orthopaedic surgeon.
methodsAdministrative healthcare databases in Ontario, Canada were linked to identify all patients making an initial ambulatory visit to orthopaedic surgeons between October 1(st), 2004 and September 30(th), 2005. Logistic regression was used to examine predictors of not receiving surgery within 18 months.
resultsOf the 477,945 patients in the cohort 49% visited orthopaedic surgeons for injury, and 24% for arthritis. Overall, 79.3% did not receive surgery within 18 months of the initial visit, which varied somewhat by diagnosis at first visit (84.5% for injury and 73.0% for arthritis) with highest proportions in the 0-24 and 25-44 age groups. The distribution by income quintile of patients visiting was skewed towards higher incomes. Regression analysis for each diagnostic group showed that younger patients were significantly more likely to be non-surgical than those aged 65+ years (age 0-24: OR 3.45 95%CI 3.33-3.57; age 25-44: OR 1.30 95%CI 1.27-1.33). The odds of not getting surgery were significantly higher for women than men for injury and other conditions; the opposite was true for arthritis and bone conditions.
conclusionA substantial proportion of referrals were for expert diagnosis or advice on management and treatment. The findings also suggest socioeconomic inequalities in access to orthopaedic care. Further research is needed to investigate whether the high caseload of non-surgical cases affects waiting times to see a surgeon. This paper contributes to the development of evidence-based strategies to streamline access to surgery, and to develop models of care for non-surgical patients to optimize the use of scarce orthopaedic surgeon resources and to enhance the management of musculoskeletal disorders across the care continuum.
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Registered trials
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