Evidence map›Paper›PMID 38413981›Full record

ArticleInternational journal for equity in health2024

Gender health gap pre- and post-joint arthroplasty: identifying affected patient-reported health domains.

Viktoria Steinbeck, Anja Yvonne Bischof, Lukas Schöner, Benedikt Langenberger, David Kuklinski, Alexander Geissler, Christoph Pross, Reinhard Busse

Abstract read
In one paragraph

Article in International journal for equity in health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Trial
  2. From preoperative to postoperative: gender differences in elective ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026
    Article
  3. Article
  4. Observational
  5. 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

8 authors.

Viktoria SteinbeckDepartment of Healthcare Management, School of Economics and Management, Technical University Berlin, Strasse Des 17 Juni 135, Berlin, 10623, Germany. steinbeck@tu-berlin.de.
Anja Yvonne BischofSchool of Medicine, Chair of Health Economics, Policy and Management, University of St. Gallen, St. Gallen, Switzerland.
Lukas SchönerDepartment of Healthcare Management, School of Economics and Management, Technical University Berlin, Strasse Des 17 Juni 135, Berlin, 10623, Germany.
Benedikt LangenbergerDepartment of Healthcare Management, School of Economics and Management, Technical University Berlin, Strasse Des 17 Juni 135, Berlin, 10623, Germany.
David KuklinskiSchool of Medicine, Chair of Health Economics, Policy and Management, University of St. Gallen, St. Gallen, Switzerland.
Alexander GeisslerSchool of Medicine, Chair of Health Economics, Policy and Management, University of St. Gallen, St. Gallen, Switzerland.
Christoph ProssDepartment of Healthcare Management, School of Economics and Management, Technical University Berlin, Strasse Des 17 Juni 135, Berlin, 10623, Germany.
Reinhard BusseDepartment of Healthcare Management, School of Economics and Management, Technical University Berlin, Strasse Des 17 Juni 135, Berlin, 10623, Germany.

Funding

Gemeinsame Bundesausschuss 01NVF18016
6 · The paper itself

Abstract

backgroundAs patient-reported outcomes (PROs) gain prominence in hip and knee arthroplasty (HA and KA), studies indicate PRO variations between genders. Research on the specific health domains particularly impacted is lacking. Hence, we aim to quantify the gender health gap in PROs for HA/KA patients, differentiating between general health, health-related quality of life (HrQoL), physical functioning, pain, fatigue, and depression.

methodsThe study included 3,693 HA patients (1,627 men, 2,066 women) and 3,110 KA patients (1,430 men, 1,680 women) receiving surgery between 2020 to 2021 in nine German hospitals, followed up until March 2022. Questionnaires used were: EQ-VAS, EQ-5D-5L, HOOS-PS, KOOS-PS, PROMIS-F-SF, PROMIS-D-SF, and a joint-specific numeric pain scale. PROs at admission, discharge, 12-months post-surgery, and the change from admission to 12-months (PRO-improvement) were compared by gender, tested for differences, and assessed using multivariate linear regressions. To enable comparability, PROs were transformed into z-scores (standard deviations from the mean).

resultsObserved differences between genders were small in all health domains and differences reduced over time. Men reported significantly better health versus women pre-HA (KA), with a difference of 0.252 (0.224) standard deviations from the mean for pain, 0.353 (0.243) for fatigue (PROMIS-F-SF), 0.327 (0.310) for depression (PROMIS-D-SF), 0.336 (0.273) for functionality (H/KOOS-PS), 0.177 (0.186) for general health (EQ-VAS) and 0.266 (0.196) for HrQoL (EQ-5D-5L). At discharge, the gender health gap reduced and even disappeared for some health dimensions since women improved in health to a greater extent than men. No gender health gap was observed in most PRO-improvements and at month 12.

conclusionsMen experiencing slightly better health than women in all health dimensions before surgery while experiencing similar health benefits 12-months post-surgery, might be an indicator of men receiving surgery inappropriately early, women unnecessarily late or both. As studies often investigate the PRO-improvement, they miss pre-surgery gender differences, which could be an important target for improvement initiatives in patient-centric care. Moreover, future research on cutoffs for meaningful between-group PRO differences per measurement time would aid the interpretation of gender health disparities.

trial registrationGerman Register for Clinical Trials, DRKS00019916, 26 November 2019.

Indexed as

PainQuality of LifeArthroplastyFatigueFemaleHumansMalePatient Reported Outcome MeasuresSurveys and QuestionnairesTreatment OutcomeGender health gapHealth disparitiesPatient-reported outcomes

Identifiers

PMID38413981
PMCPMC10900674

What OpenQuestion holds

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LicenceCC BY
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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.