Evidence mapPaperPMID 41325592Full record

ArticleJournal of health services research & policy2026

Persistent use of body mass index policies as a barrier to surgery: Prevalence and analysis of policies across England in 2025.

Kevin Ofosu, Katie Whale, Joanna McLaughlin

Abstract read
In one paragraph

Article in Journal of health services research & policy, 2026. 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

3 authors.

Kevin OfosuPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0009-0004-2807-5423
Katie WhalePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-0012-7103
Joanna McLaughlinPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0001-9921-4698

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BackgroundIntegrated Care Boards (ICBs) in England are responsible for commissioning healthcare services and setting access policies for procedures such as hip and knee replacement surgery. While the National Institute for Health and Care Excellence (NICE) advises against body mass index (BMI)-based restrictions, many ICBs impose such criteria. This study examines the prevalence and content of these policies to understand their impact on equitable healthcare access.MethodsA qualitative content analysis was conducted to systematically evaluate the policies set by all 42 ICBs in England regarding access to hip and knee replacement surgery for patients living with obesity. Policies were collected from official ICB websites and Google searches, completed in February 2025, and categorised as: no policy, restrictive policy, and non-restrictive policy. The alignment of these policies with clinical guidance was assessed, focusing on their potential impact on equitable healthcare access.ResultsPolicy documents were identified for 41 ICBs: 26 included weight management guidance and 15 imposed BMI-based restrictions on joint replacement referral eligibility. Policies varied in naming, terminology, and specificity, risking inconsistencies in interpretation and implementation. Some ICBs (

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeBody Mass IndexHealth PolicyHealth Services AccessibilityEnglandHumansObesityState Medicinearthroplastyobesitypolicy inequalities

Identifiers

PMID41325592
PMCPMC13263469

What Socratic holds

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Registered trials

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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 Socratic graph.