Evidence map›Paper›PMID 24682278›Full record

SynthesisWorld journal of surgery2015

Charitable platforms in global surgery: a systematic review of their effectiveness, cost-effectiveness, sustainability, and role training.

Mark G Shrime, Ambereen Sleemi, Thulasiraj D Ravilla

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
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  5. Candidate Quality Measures for Orthopaedic Surgery Outreach Trips: A Systematic Review.The Journal of the American Academy of Orthopaedic Surgeons · 2021
    Pooled it
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  8. International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Guideline
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  12. Article
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  16. Review
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  18. A call for inclusion of arthroplasty as essential surgery.Bulletin of the World Health Organization · 2026
    Article
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  20. Article

33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Mark G ShrimeHarvard Interfaculty Initiative in Health Policy, 14 Story Street, 4th Floor, Cambridge, MA, 02138, USA, shrime@gmail.com.
Ambereen Sleemi
Thulasiraj D Ravilla

Funding

Program in Cancer Research Outcomes Training (PCORT)R25CA092203 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI GAZELLE, G SCOTT · 2002 to 2016
$8.2M
NCI NIH HHS R25 CA092203
6 · The paper itself

Abstract

objectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.

methodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.

resultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.

conclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

Indexed as

Global HealthInternational CooperationCost-Benefit AnalysisDelivery of Health CareGeneral SurgeryHumansMedical MissionsTreatment Outcome

Identifiers

PMID24682278
PMCPMC4179995

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.