Evidence map›Paper›PMID 40379273›Full record

ReviewBMJ global health2025

A methodological review of patient healthcare-seeking journeys from symptom onset to receipt of care.

Charity Oga-Omenka, Angelina Sassi, Nathaly Aguilera Vasquez, Namrata Rana, Mohammad Yasir Essar, Darryl Ku, Hanna Diploma, Lavanya Huria, Kiran Saqib, Rishav Das and 2 more

Abstract readReview
In one paragraph

Review in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

12 authors.

Charity Oga-OmenkaSchool of Public Health Sciences, University of Waterloo, Waterloo, Canada omenkac@gmail.com.
Angelina SassiEpidemiology, Biostatistics, and Occupational Health, McGill University Faculty of Medicine and Health Sciences, Montreal, Canada.ORCID http://orcid.org/0000-0002-5807-6388
Nathaly Aguilera VasquezMcGill International Tuberculosis Centre, Montreal, Canada.ORCID http://orcid.org/0000-0002-1019-8597
Namrata RanaMcGill University International Tuberculosis Centre, Montreal, Canada.
Mohammad Yasir EssarMcGill University International Tuberculosis Centre, Montreal, Canada.
Darryl KuSchool of Public Health Sciences, University of Waterloo, Waterloo, Canada.ORCID http://orcid.org/0009-0006-0464-0322
Hanna DiplomaUniversity of Waterloo, Waterloo, Canada.
Lavanya HuriaMcGill University, Montreal, Canada.
Kiran SaqibSchool of Public Health Sciences, University of Waterloo, Waterloo, Canada.ORCID http://orcid.org/0000-0002-9663-2402
Rishav DasResearch Institute of the McGill University Health Centre, and McGill International TB Centre, Montreal, Canada, Research Institute of the McGill University Health Centre, Montreal, Canada.
Guy StallworthyBill & Melinda Gates Foundation, Seattle, Washington, USA.
Madhukar PaiEpidemiology & Biostats, McGill University, Montreal, Canada.ORCID http://orcid.org/0000-0003-3667-4536

Funding

Gates Foundation INV-022420
6 · The paper itself

Abstract

backgroundFor many diseases, early diagnosis and treatment are more cost-effective, reduce community spread of infectious diseases and result in better patient outcomes. However, healthcare-seeking and diagnoses for several diseases are unnecessarily delayed. For example, in 2022, 3 million and 5.6 million people living with tuberculosis (TB) and HIV, respectively, were undiagnosed. Many patients never access appropriate testing, remain undiagnosed after testing or drop out shortly after treatment initiation. This underscores challenges in accessing healthcare for many individuals. Understanding healthcare-seeking obstacles can expose bottlenecks in healthcare delivery and promote equity of access. We aimed to synthesise methodologies used to portray healthcare-seeking trajectories and provide a conceptual framework for patient journey analyses. DESIGN/

methodsWe conducted a literature search using keywords related to "patient/care healthcare-seeking/journey/pathway analysis" AND "TB" OR "infectious/pulmonary diseases" in PubMed, CINAHL, Web of Science and Global Health (OVID). From a preliminary scoping search and expert consultation, we developed a conceptual framework and honed the key data points necessary to understand patients' healthcare-seeking journeys, which then served as our inclusion criteria for the subsequent expanded review. Retained papers included at least three of these data points.

resultsOur conceptual framework included five data points and seven related indicators that contribute to understanding patients' experiences during healthcare-seeking. We retained 66 studies that met our eligibility criteria. Most studies (56.3%) were in Central and Southeast Asia, explored TB healthcare-seeking experiences (76.6%), were quantitative (67.2%), used in-depth, semistructured or structured questionnaires for data collection (73.4%). Healthcare-seeking journeys were explored, measured and portrayed in different ways, with no consistency in included information.

conclusionsWe synthesised various methodologies in exploring patient healthcare-seeking journeys and found crucial data points necessary to understand challenges patients encounter when interacting with health systems and offer insights to researchers and healthcare practitioners. Our framework proposes a standardised approach to patient journey research.

Indexed as

Patient Acceptance of Health CareHealth Services AccessibilityHumansTuberculosisCohort studyCross-sectional surveyGlobal HealthQualitative studyReview

Identifiers

PMID40379273
PMCPMC12086929

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.