Evidence map›Paper›PMID 34346738›Full record

ArticleBone & joint open2021

What can we learn from the experiences and expectations of patients on growing waiting lists for planned care in the COVID-19 pandemic?

Kunal Kulkarni, Rohi Shah, Maria Armaou, Paul Leighton, Jitendra Mangwani, Joseph Dias

Open access · goldAbstract read
In one paragraph

Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
3.0field-weighted citation impact, top 7% 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

10 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
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  4. 'Before and After'. The Journey of Patients With Low Back Pain Consulting in Elective Spine Surgery Clinics. A Qualitative Study Protocol.Health expectations : an international journal of public participation in health care and health policy · 2025
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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

6 authors at 2 institutions in 1 country.

Kunal KulkarniAToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester, UK.
Rohi ShahAToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester, UK.
Maria ArmaouAToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester, UK.
Paul LeightonSchool of Medicine, University of Nottingham, Nottingham, UK.
Jitendra MangwaniAToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester, UK.
Joseph DiasAToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester, UK.
University Hospitals of Leicester NHS Trust · GBUniversity of Nottingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsCOVID-19 has compounded a growing waiting list problem, with over 4.5 million patients now waiting for planned elective care in the UK. Views of patients on waiting lists are rarely considered in prioritization. Our primary aim was to understand how to support patients on waiting lists by hearing their experiences, concerns, and expectations. The secondary aim was to capture objective change in disability and coping mechanisms.

methodsA minimum representative sample of 824 patients was required for quantitative analysis to provide a 3% margin of error. Sampling was stratified by body region (upper/lower limb, spine) and duration on the waiting list. Questionnaires were sent to a random sample of elective orthopaedic waiting list patients with their planned intervention paused due to COVID-19. Analyzed parameters included baseline health, change in physical/mental health status, challenges and coping strategies, preferences/concerns regarding treatment, and objective quality of life (EuroQol five-dimension questionnaire (EQ-5D), Generalized Anxiety Disorder 2-item scale (GAD-2)). Qualitative analysis was performed via the Normalization Process Theory.

resultsA total of 888 patients responded. Better health, pain, and mood scores were reported by upper limb patients. The longest waiters reported better health but poorer mood and anxiety scores. Overall, 82% had tried self-help measures to ease symptoms; 94% wished to proceed with their intervention; and 21% were prepared to tolerate deferral. Qualitative analysis highlighted the overall patient mood to be represented by the terms 'understandable', 'frustrated', 'pain', 'disappointed', and 'not happy/depressed'. COVID-19-mandated health and safety measures and technology solutions were felt to be implemented well. However, patients struggled with access to doctors and pain management, quality of life (physical and psychosocial) deterioration, and delay updates.

conclusionThis is the largest study to hear the views of this 'hidden' cohort. Our findings are widely relevant to ensure provision of better ongoing support and communication, mostly within the constraints of current resources. In response, we developed a reproducible local action plan to address highlighted issues. Cite this article:

Indexed as

anxietyanxiety scorescliniciansCommunicationCOVID-19COVID-19 pandemicEuroQol five-dimension questionnaire (EQ-5D)lower limbpain managementPatientSelf-helpspineupper limbvisual analogue scale (VAS)Waiting list

Identifiers

PMID34346738
PMCPMC8384445
OpenAlexW3191574013

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.