Evidence map›Paper›PMID 29025827›Full record

ArticleBMJ open2017

Influence of social deprivation on provision of bariatric surgery: 10-year comparative ecological study between two UK specialist centres.

Shivam Bhanderi, Mushfique Alam, Jacob Henry Matthews, Gavin Rudge, Hamish Noble, David Mahon, Martin Richardson, Richard Welbourn, Paul Super, Rishi Singhal

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Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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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

10 authors.

Shivam BhanderiFoundation Year Doctor, West Midlands Deanery, Birmingham, UK.
Mushfique AlamFoundation Year Doctor, West Midlands Deanery, Birmingham, UK.
Jacob Henry MatthewsFoundation Year Doctor, West Midlands Deanery, Birmingham, UK.
Gavin RudgeDepartment of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK.
Hamish NobleDepartment of Upper GI and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK.
David MahonDepartment of Upper GI and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK.
Martin RichardsonUpper GI and Bariatric Unit, Heart of England NHS Foundation Trust, Birmingham, UK.
Richard WelbournDepartment of Upper GI and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK.
Paul SuperUpper GI and Bariatric Unit, Heart of England NHS Foundation Trust, Birmingham, UK.
Rishi SinghalUpper GI and Bariatric Unit, Heart of England NHS Foundation Trust, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the effect of residential location and socioeconomic deprivation on the provision of bariatric surgery.

designRetrospective cross-sectional ecological study.

settingPatients resident local to one of two specialist bariatric units, in different regions of the UK, who received obesity surgery between 2003 and 2013.

methodsDemographic data were collected from prospectively collected databases. Index of Multiple Deprivation (IMD 2010) was used as a measure of socioeconomic status. Obesity prevalences were obtained from Public Health England (2006). Patients were split into three IMD tertiles (high, median, low) and also tertiles of time. A generalised linear model was generated for each time period to investigate the effect of socioeconomic deprivation on the relationship between bariatric case count and prevalence of obesity. We used these to estimate surgical intervention provided in each population in each period at differing levels of deprivation.

resultsData were included from 1163 bariatric cases (centre 1-414, centre 2-749). Incidence rate ratios (IRRs) were calculated to measure the associations between predictor and response variables. Associations were highly non-linear and changed over the 10-year study period. In general, the relationship between surgical case volume and obesity prevalence has weakened over time, with high volumes becoming less associated with prevalence of obesity. DISCUSSION: As bariatric services have matured, the associations between demand and supply factors have changed. Socioeconomic deprivation is not apparently a barrier to service provision more recently, but the positive relationships between obesity and surgical volume we would expect to find are absent. This suggests that interventions are not being taken up in the areas of need. We recommend a more detailed national analysis of the relationship between supply side and demand side factors in the provision of bariatric surgery.

Indexed as

Poverty AreasResidence CharacteristicsBariatric SurgeryCatchment Area, HealthCross-Sectional StudiesFemaleHealth Services AccessibilityHumansMaleMiddle AgedObesityRetrospective StudiesUnited Kingdomhealth economicspublic healthsocial medicinesurgery

Identifiers

PMID29025827
PMCPMC5652494

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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.