Evidence map›Paper›PMID 34564050›Full record

ArticleBlood cells, molecules & diseases2021

Global geographic differences in healthcare utilization for sickle cell disease pain crises in the CASiRe cohort.

Crawford Strunk, Immacolata Tartaglione, Connie M Piccone, Raffaella Colombatti, Biree Andemariam, Deepa Manwani, Ashya Smith, Haikel Haile, Esther Kim, Samuel Wilson and 16 more

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

Article in Blood cells, molecules & diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Factors Associated with Healthcare Utilization in Children with Sickle Cell Disease in Saudi Arabia.International journal of environmental research and public health · 2026
    Observational
  6. Optimizing the "right" patient selection for treatment for sickle cell disease.Hematology. American Society of Hematology. Education Program · 2025
    Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
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

26 authors at 11 institutions in 3 countries.

Crawford StrunkDepartment of Pediatric Hematology/Oncology, ProMedica Russell J. Ebeid Children's Hospital, Toledo, OH, USA. Electronic address: Crawford.Strunk@ProMedica.org.
Immacolata TartaglioneDepartment of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Connie M PicconePediatric Hematology, Carle Foundation Hospital, Urbana, IL, USA.
Raffaella ColombattiClinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy.
Biree AndemariamNew England Sickle Cell Institute, Division of Hematology-Oncology, Neag Comprehensive Cancer Center, UCONN Health, University of Connecticut, Farmington, CT, USA.
Deepa ManwaniDepartment of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA.
Ashya SmithDivision of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
Haikel HaileDivision of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
Esther KimDivision of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
Samuel WilsonDivision of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
Eugenia Vicky AsareGhana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana.
Angela RiversUCSF Benioff Children's Hospital Oakland, Oakland, CA, USA.
Fatimah FarooqDivision of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
Rebekah UrbonyaDivision of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
Donna BoruchovDepartment of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
Gifty Dankwah BoatemaaDepartment of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana.
Silverio PerrottaDepartment of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Ivy EkemGhana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana.
Laura SainatiClinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy.
Sudha RaoDepartment of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
William ZempskyDivision of Pain and Palliative Care, Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA.
Fredericka SeyGhana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana.
Charles Antwi-BoasiakoDepartment of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana; Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana.
Catherine SegbefiaDepartment of Child Health, Korle Bu Teaching Hospital, Accra, Ghana; Department of Child Health, University of Ghana Medical School, University of Ghana, Accra, Ghana.
Baba InusaDepartment of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, London, UK.
Andrew D CampbellDivision of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics, Divison of Hematology, Children's National Hospital, George Washington University School of Medicine Health Sciences, Washington, DC, USA.
University of Michigan–Ann Arbor · USKorle Bu Teaching Hospital · GHUniversity of Campania "Luigi Vanvitelli" · ITAzienda Ospedaliera di Padova · ITCarle Foundation Hospital · USChildren's Hospital at Montefiore · USProMedica Russell J. Ebeid Children's Hospital · USUConn Health · USUCSF Benioff Children's Hospital · USUniversity of Ghana · GHUniversity of Padua · IT

Funding

University of Michigan Minority Health and Health Disparities International Research Training ProgramT37MD001425 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BOULTON, MATTHEW LESTER · 2005 to 2025
$4.8M
NIMHD NIH HHS T37 MD001425
6 · The paper itself

Abstract

backgroundSickle cell disease (SCD) is characterized by frequent, unpredictable pain episodes and other vaso-occlusive crises (VOCs) leading to significant healthcare utilization. VOC frequency is often an endpoint in clinical trials investigating novel therapies for this devastating disease. PROCEDURE: The Consortium for the Advancement of Sickle Cell Research (CASiRe) is an international collaboration investigating clinical severity in SCD using a validated questionnaire and medical chart review standardized across four countries (United States, United Kingdom, Italy and Ghana).

resultsThis study, focused on pain crisis incidence and healthcare utilization, included 868 patients, equally represented according to age and gender. HgbSS was the most common genotype. Patients from Ghana used the Emergency Room/Day Hospital for pain more frequently (annualized mean 2.01) than patients from other regions (annualized mean 1.56 U.S.; 1.09 U.K.; 0.02 Italy), while U.K. patients were hospitalized for pain more often (annualized mean: U.K. 2.98) than patients in other regions (annualized mean 1.98 U.S.; 1.18 Ghana; Italy 0.54). Italy's hospitalization rate for pain (annualized mean: 0.57) was nearly 20 times greater than its emergency room/day hospital only visits for pain (annualized mean: 0.03). When categorized by genotype and age, similar results were seen.

conclusionsGeographic differences in pain crisis frequency and healthcare utilization may correlate with variable organization of healthcare systems among countries and should be considered regarding trial design, endpoints, and analysis of results when investigating novel agents for clinical benefit.

Indexed as

Pain ManagementPatient Acceptance of Health CareAdolescentAdultAnemia, Sickle CellFemaleGhanaHumansItalyMalePainUnited KingdomUnited StatesYoung AdultComplicationsGeographic differencesHealth resources utilizationPain crisisSickle cell disease

Identifiers

PMID34564050
PMCPMC8643307
OpenAlexW3201818791

What OpenQuestion holds

Textmetadata
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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.