ReviewLancet (London, England)2013
Understanding of regional variation in the use of surgery.
Review in Lancet (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 235 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
235 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials.BMJ (Clinical research ed.) · 2023Pooled it
- Global Perspectives on Radiotherapy Utilization for Pancreatic Ductal Adenocarcinoma.Journal of gastrointestinal cancer · 2026Article
- Hip arthroscopy in Sweden: a nationwide registry study of socioeconomic characteristics, regional variation, and sick leave patterns.Acta orthopaedica · 2026Article
- Regional Variation in Reimbursement for Body Contouring Surgery: A Claims-based Analysis across the United States.Plastic and reconstructive surgery. Global open · 2026Article
- Treatment-center variations in open versus closed reduction for nonelderly femoral neck fractures.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Regional Variation in Wrist Ligament Surgery Incidence: A 25-year Nationwide Register Study.Plastic and reconstructive surgery. Global open · 2026Article
- Surgical and oncologic outcomes of cT4b rectal cancer: a propensity score-matched comparison between a university center and regional hospitals.Annals of coloproctology · 2026Article
- Geography and Opportunity: The Influence of Residency Location on Plastic Surgery Resident Case Volume-A 9-year Review of 1902 Graduates.Plastic and reconstructive surgery. Global open · 2026Article
- Clinical Context Variables Collectively Rival Model Choice in Embedding-Based Retrieval: Multi-Corpus Benchmark Study.JMIR medical informatics · 2026Article
- Amygdala and nucleus accumbens activation are associated with treatment choice in knee osteoarthritis: an fMRI study.Arthroplasty (London, England) · 2026Article
- The role of patient and surgeon characteristics on the treatment decision for displaced midshaft clavicle fractures in athletes: a global survey.JSES reviews, reports, and techniques · 2026Article
- Disparities in gynecological care capacity in China: a national assessment using the structure-process-outcome framework.BMC health services research · 2026Article
- Hospital variation in the treatment of cT1a renal cancer.BJUI compass · 2026Article
- Early postoperative behavioral adherence is associated with recovery efficiency in older adults undergoing colorectal cancer surgery.BMC surgery · 2026Article
- Trends in Open Aortic Valve Surgery in the United States: Descriptive Analysis of Sociodemographic Factors in Patient Selection.BMC surgery · 2026Article
- Atopic Dermatitis in Denmark: Regional Variation.Acta dermato-venereologica · 2026Article
- Conducting rigorous implementation evaluations in real word settings: lessons from a consensus approach to perioperative pathway implementation for elective surgery.Implementation science communications · 2026Article
- Treatment variation in acute management of patients with aneurysmal subarachnoid hemorrhage: a multicenter case vignette study.Brain & spine · 2026Article
- Digital Versus In-Person Physical Therapy in Adults With Musculoskeletal Conditions: Retrospective Matched-Cohort Analysis of Surgery and Low-Value Surgical Rates.Journal of medical Internet research · 2025Article
- Surgical Low-Value Care Between Fee-For-Service and Salaried Health Care Systems.JAMA network open · 2025Article
175 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
The use of common surgical procedures varies widely across regions. Differences in illness burden, diagnostic practices, and patient attitudes about medical intervention explain only a small degree of regional variation in surgery rates. Evidence suggests that surgical variation results mainly from differences in physician beliefs about the indications for surgery, and the extent to which patient preferences are incorporated into treatment decisions. These two components of clinical decision making help to explain the so-called surgical signatures of specific procedures, and why some consistently vary more than others. Variation in clinical decision making is, in turn, affected by broad environmental factors, including technology diffusion, supply of specialists, local training frameworks, financial incentives, and regulatory factors, which vary across countries. Better scientific evidence about the comparative effectiveness of surgical and non-surgical interventions could help to mitigate regional variation, but broader dissemination of shared decision aids will be essential to reduce variation in preference-sensitive disorders.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.