Evidence map›Paper›PMID 31418524›Full record

ArticleANZ journal of surgery2019

Patterns of immediate breast reconstruction in New South Wales, Australia: a population-based study.

Yingyu Feng, Kathy Flitcroft, Marina T van Leeuwen, Adam G Elshaug, Andrew Spillane, Sallie-Anne Pearson

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Article in ANZ journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Yingyu FengMenzies Centre for Health Policy, Sydney School of Public Health, Charles Perkins Centre D17, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0001-8331-8310
Kathy FlitcroftNorthern Clinical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-4945-0857
Marina T van LeeuwenCentre for Big Data Research in Health, The University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-1570-2852
Adam G ElshaugMenzies Centre for Health Policy, Sydney School of Public Health, Charles Perkins Centre D17, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-4939-5379
Andrew SpillaneNorthern Clinical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-8354-434X
Sallie-Anne PearsonMenzies Centre for Health Policy, Sydney School of Public Health, Charles Perkins Centre D17, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0001-7137-6855

Funding

National Health and Medical Research Council project grant ID 1109626
6 · The paper itself

Abstract

backgroundThe rate of immediate breast reconstruction (IBR) following mastectomy for breast cancer in Australia is low and varies between regions. To date, no previous Australian studies have examined IBR rates between all hospitals within a particular jurisdiction, despite hospitals being an important known contributor to variation in IBR rates in other countries.

methodsWe used cross-classified random-effects logistic regression models to examine the inter-hospital variation in IBR rates by using data on 7961 women who underwent therapeutic mastectomy procedures in New South Wales (NSW) between January 2012 and June 2015. We derived IBR rates by patient-, residential neighbourhood- and hospital-related factors and investigated the underlying drivers for the variation in IBR.

resultsWe estimated the mean IBR rate across all hospitals performing mastectomy to be 17.1% (95% Bayesian credible interval (CrI) 12.1-23.1%) and observed wide inter-hospital variation in IBR (variance 4.337, CrI 2.634-6.889). Older women, those born in Asian countries (odds ratio (OR) 0.5, CrI 0.4-0.6), residing in neighbourhoods with lower socioeconomic status (OR 0.7, CrI 0.5-0.8 for the most disadvantaged), and who underwent surgery in public hospitals (OR 0.4, CrI 0.1-1.0) were significantly less likely to have IBR. Women residing in non-metropolitan areas and attending non-metropolitan hospitals were significantly less likely to undergo IBR than their metropolitan counterparts attending metropolitan hospitals.

conclusionWide inter-hospital variation raises concerns about potential inequities in access to IBR services and unmet demand in certain areas of NSW. Explaining the underlying drivers for IBR variation is the first step in identifying policy solutions to redress the issue.

Indexed as

AdultAgedAged, 80 and overAustraliaBreast NeoplasmsCarcinoma, Intraductal, NoninfiltratingFemaleHealth Services AccessibilityHospitalsHumansMammaplastyMastectomyMiddle AgedNew South WalesSocial Classbreast cancerbreast reconstructioncohort studyhealth services accessibilitymultilevel analysis

Identifiers

PMID31418524
PMCPMC6852512

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LicenceCC BY-NC
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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.