ArticleOpen heart2023
Impact of gender, ethnicity and social deprivation on access to surgical or transcatheter aortic valve replacement in aortic stenosis: a retrospective database study in England.
Article in Open heart, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- The Perpetual Cycle of Racial Bias in Healthcare and Healthcare Education: A Systematic Review.Journal of racial and ethnic health disparities · 2026Pooled it
- Temporal Trends in Hospitalization and Interventions for Aortic Stenosis in Canada, 2012-2024.CJC open · 2026Article
- A Review of Sex Differences in Patients with Aortic Stenosis: A Focus on Diagnostic and Treatment Differences, a Narrative Review.Journal of clinical medicine · 2026Review
- Automated Referral Prompts Reveal Lack of Equitable Access to Care in Patients With Aortic Stenosis.Structural heart : the journal of the Heart Team · 2026Article
- Left Ventricular Geometry Improves Prediction of Sex-Specific Post-TAVR Remodeling in Aortic Stenosis.medRxiv : the preprint server for health sciences · 2026Article
- Comparing access to, and outcomes following, TAVI by biological sex.Open heart · 2025Article
- Ethnic variation in aortic root anatomy and prosthesis sizing in TAVI: a UK matched study.European heart journal. Imaging methods and practice · 2025Article
- Understanding Aortic Stenosis and Transcatheter Aortic Valve Replacement in Women.Structural heart : the journal of the Heart Team · 2025Review
- Surgical and transcatheter aortic valve interventions for aortic stenosis in England: sociodemographic variations in treatment trends and outcome over 20 years.Heart (British Cardiac Society) · 2025Article
- Postcode health inequalities in aortic valve surgery in North East England: retrospective study of disparities in presentation and hospital outcomes.BMJ public health · 2025Article
- Predictors of requirement for urgent versus elective TAVI and comparison of short and medium outcomes.The British journal of cardiology · 2025Article
- Misuse of Guidelines Could Disadvantage and Harm Patients.Journal of evidence-based medicine · 2024Article
- Inequalities in access to and outcomes of cardiac surgery in England: retrospective analysis of Hospital Episode Statistics (2010-2019).Heart (British Cardiac Society) · 2024Article
- Stroke after heart valve surgery: a single center institution report.Journal of cardiothoracic surgery · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess gender, ethnicity, and deprivation-based differences in provision of aortic valve replacement (AVR) in England for adults with aortic stenosis (AS).
methodsWe retrospectively identified adults with AS from the English Hospital Episode Statistics (HES) between April 2016 and March 2019 and those who subsequently had an AVR. We separately used HES-linked Clinical Practice Research Datalink (CPRD) to identify people with AVR and evaluate the timeliness of their procedure (CPRD-AVR cohort). ORs for AVR in people with an AS diagnosis were estimated using multivariable logistic regression adjusted for age, region and comorbidity. AVR was considered timely if performed electively and without evidence of cardiac decompensation before AVR.
results183 591 adults with AS were identified in HES; of these, 31 436 underwent AVR. The CPRD-AVR cohort comprised 10 069 adults. Women had lower odds of receiving AVR compared with men (OR 0.65; 95% CI 0.63 to 0.66); as did people of black (OR 0.70; 95% CI 0.60 to 0.82) or South Asian (OR 0.75; 95% CI 0.69 to 0.82) compared with people of white ethnicities. People in the most deprived areas were less likely to receive AVR than the least deprived areas (OR 0.8; 95% CI 0.75 to 0.86). Timely AVR occurred in 65% of those of white ethnicities compared with 55% of both those of black and South Asian ethnicities. 77% of the least deprived had a timely procedure compared with 58% of the most deprived; there was no gender difference.
conclusionsIn this large, national dataset, female gender, black or South Asian ethnicities and high deprivation were associated with significantly reduced odds of receiving AVR in England. A lower proportion of people of minority ethnicities or high deprivation had a timely procedure. Public health initiatives may be required to increase clinician and public awareness of unconscious biases towards minority and vulnerable populations to ensure timely AVR for everyone.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.