Evidence map›Paper›PMID 41779633›Full record

SynthesisThe British journal of surgery2026

Systematic review of the Lancet Commission on Global Surgery indicators with quality assessment of modelled estimates.

Theophilus T K Anyomih, Anita E Agbeko, Alazar B Aregawi, Kathryn Chu, Richard Crawford, Ewen M Harrison, Sivesh Kamarajah, Elizabeth Li, John G Meara, Albane Mulliez and 6 more

Abstract readSystematic Review
In one paragraph

Synthesis in The British journal of surgery, 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. Observational
  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

16 authors.

Theophilus T K AnyomihNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Anita E AgbekoGhana Hub, NIHR Global Health Research Unit on Global Surgery, University of Developmental Studies, Tamale, Ghana.
Alazar B AregawiCollege of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Kathryn ChuCentre for Global Surgery, Stellenbosch University, Stellenbosch, South Africa.
Richard CrawfordDepartment of Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Ewen M HarrisonNIHR Global Health Research Unit on Global Surgery, University of Edinburgh, Edinburgh, UK.
Sivesh KamarajahNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.ORCID 0000-0002-2748-0011
Elizabeth LiNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
John G MearaProgram in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.
Albane MulliezMedical School of Tours, Université de Tours (University of Tours), Tours, France.
Soha SobhyWHO Collaborating Centre for Global Women's Health, University of Birmingham, Birmingham, UK.
Richard SullivanInstitute of Cancer Policy, King's College London, London, UK.ORCID 0000-0002-6435-1825
Elizabeth TissinghKing's Global Health Partnerships, School of Life Course and Population Sciences, King's College London, London, UK.
Thomas G WeiserDepartment of Surgery, Stanford University, Palo Alto, California, USA.
Aneel BhanguNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.ORCID 0000-0001-5999-4618
Dmitri NepogodievNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.ORCID 0000-0002-2171-2862

Funding

National Institute for Health and Care Research (NIHR) Global Health Research Unit NIHR133364
6 · The paper itself

Abstract

backgroundThe Lancet Commission on Global Surgery (LCoGS) defined six indicators with 2030 targets to track national surgical system performance. The aim of this systematic review was to evaluate national reporting and attainment of benchmarks for each indicator and to assess the quality of modelling studies used to fill data gaps.

methodsSeven bibliographic databases (1 April 2015-24 July 2024) and government domains of 48 countries committed to National Surgical, Obstetric, and Anaesthesia Plans were searched. Records providing national estimates of any LCoGS indicator were eligible. The primary outcome was the proportion of World Bank-classified countries meeting indicator benchmarks and the secondary outcome was the quality of modelled national estimates. This systematic review was prospectively registered in PROSPERO, the international prospective register of systematic reviews (CRD420250650890).

resultsOf 4245 records retrieved, 44 studies were included (35 research articles and 9 policy documents). Among 217 World Bank-classified countries, access to timely essential surgery (indicator 1) was reported for 94 countries (39% meeting benchmark), specialist surgical workforce density (indicator 2) was reported for 167 countries (50.3% meeting benchmark), surgical volume (indicator 3) was reported for 124 countries (31.5% meeting benchmark), perioperative mortality (indicator 4) was reported for 74 countries (no benchmark was set at country level), and financial risk protection indicators (indicators 5 and 6) were reported for five countries, with none meeting either benchmark. Across indicators, high-income countries were more likely to meet benchmarks. Most modelled studies lacked transparency in data sources, statistical methods, or model validation.

conclusionReporting of LCoGS indicators remains sparse and uneven, particularly in low- and middle-income countries. Without standardized, routine measurement and minimum quality standards for modelled estimates, progress towards 2030 cannot be credibly tracked. Integrating surgical metrics into national health information systems should be a policy priority.

Indexed as

BenchmarkingGlobal HealthQuality Indicators, Health CareSurgical Procedures, OperativeDeveloping CountriesHumans

Identifiers

PMID41779633
PMCPMC13016785

What Socratic 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 Socratic graph.