Evidence map›Paper›PMID 30570764›Full record

ArticleThe British journal of surgery2019

Evaluating the collection, comparability and findings of six global surgery indicators.

H Holmer, A Bekele, L Hagander, E M Harrison, P Kamali, J S Ng-Kamstra, M A Khan, L Knowlton, A J M Leather, I H Marks and 6 more

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 2 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

59 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Observational
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

16 authors.

H HolmerWHO Collaborating Centre for Surgery and Public Health, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.ORCID 0000-0003-3745-7402
A BekeleDepartment of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
L HaganderWHO Collaborating Centre for Surgery and Public Health, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.
E M HarrisonDepartment of Clinical Surgery, Royal Infirmary of Edinburgh and Surgical Informatics, Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-5018-3066
P KamaliDivision of Plastic and Reconstructive Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
J S Ng-KamstraDepartment of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada.
M A KhanInciSioN, International Student Surgical Network, Leuven, Belgium.
L KnowltonDepartment of Surgery, Stanford University, Stanford, California, USA.
A J M LeatherKing's Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
I H MarksCharing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
J G MearaDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, USA.
M G ShrimeDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, USA.
M SmithDepartment of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
K SøreideDepartment of Clinical Surgery, Royal Infirmary of Edinburgh and Surgical Informatics, Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
T G WeiserDepartment of Clinical Surgery, Royal Infirmary of Edinburgh and Surgical Informatics, Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
J DaviesKing's Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2015, six indicators were proposed to evaluate global progress towards access to safe, affordable and timely surgical and anaesthesia care. Although some have been adopted as core global health indicators, none has been evaluated systematically. The aims of this study were to assess the availability, comparability and utility of the indicators, and to present available data and updated estimates.

methodsNationally representative data were compiled for all World Health Organization (WHO) member states from 2010 to 2016 through contacts with official bodies and review of the published and grey literature, and available databases. Availability, comparability and utility were assessed for each indicator: access to timely essential surgery, specialist surgical workforce density, surgical volume, perioperative mortality, and protection against impoverishing and catastrophic expenditure. Where feasible, imputation models were developed to generate global estimates.

resultsOf all WHO member states, 19 had data on the proportion of the population within 2h of a surgical facility, 154 had data on workforce density, 72 reported number of procedures, and nine had perioperative mortality data, but none could report data on catastrophic or impoverishing expenditure. Comparability and utility were variable, and largely dependent on different definitions used. There were sufficient data to estimate that worldwide, in 2015, there were 2 038 947 (i.q.r. 1 884 916-2 281 776) surgeons, obstetricians and anaesthetists, and 266·1 (95 per cent c.i. 220·1 to 344·4) million operations performed.

conclusionSurgical and anaesthesia indicators are increasingly being adopted by the global health community, but data availability remains low. Comparability and utility for all indicators require further resolution.

Indexed as

General SurgeryGlobal HealthHumansPhysiciansQuality Indicators, Health CareWorld Health Organization

Identifiers

PMID30570764
PMCPMC6790969

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.