Evidence map›Paper›PMID 25344482›Full record

ArticleBMJ open2014

Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study.

N Steel, A C Hardcastle, M O Bachmann, S H Richards, L T A Mounce, A Clark, I Lang, D Melzer, J Campbell

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 20% of its field
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

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Exploring Whether and How People Experiencing High Deprivation Access Diagnostic Services: A Qualitative Systematic Review.Health expectations : an international journal of public participation in health care and health policy · 2024
    Pooled it
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  3. Observational
  4. Observational
  5. Article
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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

9 authors at 3 institutions in 2 countries.

N SteelDepartment of Population Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
A C HardcastleDepartment of Population Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
M O BachmannDepartment of Population Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
S H RichardsUniversity of Exeter Medical School, Exeter, UK.
L T A MounceUniversity of Exeter Medical School, Exeter, UK.
A ClarkDepartment of Population Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
I LangNIHR CLAHRC South West Peninsula, Exeter, UK.
D MelzerUniversity of Exeter Medical School, Exeter, UK.
J CampbellUniversity of Exeter Medical School, Exeter, UK.
University of East Anglia · GBUniversity of Exeter · GBPeninsula Research · US

Funding

Project-001R01AG017644 · NIA · UNIVERSITY OF LONDON INST OF NEUROLOGY · PI Andrew Steptoe · 2000 to 2026
$56.2M
Department of Health 10/2002/06NIA NIH HHS R01 AG017644
6 · The paper itself

Abstract

objectiveWe compared the distribution by wealth of self-reported illness burden (estimated from validated scales, biomarker and reported symptoms) for angina, cataract, depression, diabetes and osteoarthritis, with the distribution of self-reported medical diagnosis and treatment. We aimed to determine if the greater illness burden borne by poorer participants was matched by appropriately higher levels of diagnosis and treatment.

designThe English Longitudinal Study of Ageing, a panel study of 12,765 participants aged 50 years and older in four waves from 2004 to 2011, selected using a stratified random sample of households in England. Distribution of illness burden, diagnosis and treatment by wealth was estimated using regression analysis. OUTCOME MEASURES: The main outcome measures were ORs for the illness burden, diagnosis and treatment, respectively, adjusted for age, sex and wealth. We estimated the illness burden for angina with the Rose Angina scale, diabetes with fasting glycosylated haemoglobin, depression with the Centre for Epidemiologic Studies Depression Scale, osteoarthritis with self-reported pain and disability and cataract with self-reported poor vision. Medical diagnoses were self-reported for all conditions. Treatment was defined as β-blocker prescription for angina, surgery for osteoarthritis and cataract, and receipt of predefined effective interventions for diabetes and depression.

resultsCompared with the wealthiest, the least wealthy participant had substantially higher odds for illness burden from any of the five conditions at all four time points, with ORs ranging from 4.2 (95% CI 2.6 to 6.8) for diabetes to 15.1 (11.4 to 20.0) for osteoarthritis. The ORs for diagnosis and treatment were smaller in all five conditions, and ranged from 0.9 (0.5 to 1.4) for diabetes treatment to 4.5 (3.3 to 6.0) for angina diagnosis.

conclusionsThe substantially higher illness burden in less wealthy participants was not matched by appropriately higher levels of diagnosis and treatment.

Indexed as

Health Status DisparitiesAgedAged, 80 and overAngina PectorisCataractDepressive DisorderDiabetes MellitusEnglandFemaleHealthcare DisparitiesHumansIncomeMaleMiddle AgedOsteoarthritisSelf ReportEPIDEMIOLOGY

Identifiers

PMID25344482
PMCPMC4212182
OpenAlexW2127542322

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.