{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:13:25Z","timestamp":1787771605680,"version":"build-2784847793"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":206,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"Canadian Institute for Health Research Applied Chair in Reproductive and Child Health"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019256","name":"NIHR Great Ormond Street Hospital Biomedical Research Centre","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100019256","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>International guidelines in 2008 recommended orchidopexy for undescended testis at 6\u201312 months of age to reduce the risk of testicular cancer and infertility. Using administrative data from England, Finland, Ontario (Canada), Scotland and Sweden (with data from Victoria (Australia) and Iceland in supplementary analyses), the aim of this study was to investigate compliance with these guidelines and identify potential socioeconomic inequities in the timing of surgery before 1 and 3 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All boys born in 2003\u20132011 with a diagnosis code of undescended testis and procedure codes indicating orchidopexy before their fifth birthday were identified from administrative health records. Trends in the proportion of orchidopexies performed before 1 and 3 years of age were investigated, as were socioeconomic inequities in adherence to the guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Across all jurisdictions, the proportion of orchidopexies occurring before the first birthday increased over the study period. By 2011, from 7\u00b76 per cent (Sweden) to 27\u00b79 per cent (Scotland) of boys had undergone orchidopexy by their first birthday and 71\u00b75 per cent (Sweden) to 90\u00b74 per cent (Scotland) by 3 years of age. There was limited evidence of socioeconomic inequities for orchidopexy before the introduction of guidelines (2008). Across all jurisdictions for boys born after 2008, there was consistent evidence of inequities in orchidopexy by the first birthday, favouring higher socioeconomic position. Absolute differences in these proportions between the highest and lowest socioeconomic groups ranged from 2\u00b75 to 5\u00b79 per cent across jurisdictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Consistent lack of adherence to the guidelines across jurisdictions questions whether the guidelines are appropriate.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs5.50329","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T10:09:52Z","timestamp":1595585392000},"page":"1117-1124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Timing of paediatric orchidopexy in universal healthcare systems: international administrative data cohort study"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2481-7755","authenticated-orcid":false,"given":"M A","family":"Jay","sequence":"first","affiliation":[{"name":"Population Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Arat","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology, Department of Medicine, Karolinska Institutet and Centre for Health Equity Studies , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Wijlaars","sequence":"additional","affiliation":[{"name":"Population Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Ajetunmobi","sequence":"additional","affiliation":[{"name":"Population Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Lu","sequence":"additional","affiliation":[{"name":"ICES , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Lei","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, The Royal Children's Hospital , Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Skerritt","sequence":"additional","affiliation":[{"name":"Bristol Royal Hospital for Children , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Goldfeld","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, The Royal Children's Hospital , Parkville, Victoria, Australia"},{"name":"Department of Paediatrics, University of Melbourne , Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Gissler","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Huddinge, Sweden"},{"name":"Information Services Department, Finnish Institute for Health and Welfare , Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Gunnlaugsson","sequence":"additional","affiliation":[{"name":"Faculty of Sociology, Anthropology and Folkloristics, University of Iceland , Reykjav\u00edk, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Hrafn J\u00f3nsson","sequence":"additional","affiliation":[{"name":"Faculty of Sociology, Anthropology and Folkloristics, University of Iceland , Reykjav\u00edk, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Hjern","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology, Department of Medicine, Karolinska Institutet and Centre for Health Equity Studies , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Guttmann","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences , Toronto, Ontario, Canada"},{"name":"Division of Paediatric Medicine, Hospital for Sick Children , Toronto, Ontario, Canada"},{"name":"ICES , Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health , Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, University of Toronto , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Population Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"2023020208102757800_bjs550329-bib-0001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2605.2007.00770.x","article-title":"The frequency of undescended testis from birth to adulthood: a review","volume":"31","author":"Sijstermans","year":"2008","journal-title":"Int J Androl"},{"key":"2023020208102757800_bjs550329-bib-0002","first-page":"492","article-title":"Management of cryptorchidism in children: guidelines","volume":"138","author":"Gapany","year":"2008","journal-title":"Swiss Med Wkly"},{"key":"2023020208102757800_bjs550329-bib-0003","volume-title":"Guidelines on Paediatric Urology","author":"Tekg\u00fcl","year":"2015"},{"key":"2023020208102757800_bjs550329-bib-0004","doi-asserted-by":"crossref","first-page":"S87","DOI":"10.1530\/EJE-08-0181","article-title":"Undescended testes: a consensus on management","volume":"159","author":"Ritzen","year":"2008","journal-title":"Eur J Endocrinol"},{"key":"2023020208102757800_bjs550329-bib-0005","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1016\/j.juro.2007.03.173","article-title":"Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months or 3 years","volume":"178","author":"Kollin","year":"2007","journal-title":"J Urol"},{"key":"2023020208102757800_bjs550329-bib-0006","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/j.urology.2011.04.057","article-title":"Testicular catch up growth: the impact of orchiopexy age","volume":"78","author":"Kim","year":"2011","journal-title":"J Urol"},{"key":"2023020208102757800_bjs550329-bib-0007","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1056\/NEJMoa067588","article-title":"Age at surgery for undescended testis and risk of testicular cancer","volume":"356","author":"Pettersson","year":"2007","journal-title":"NEJM"},{"key":"2023020208102757800_bjs550329-bib-0008","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1016\/j.juro.2007.05.166","article-title":"Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer","volume":"178","author":"Walsh","year":"2007","journal-title":"J Urol"},{"key":"2023020208102757800_bjs550329-bib-0009","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1016\/j.juro.2007.05.331","article-title":"Editorial comment","volume":"178","author":"Wood","year":"2007","journal-title":"J Urol"},{"key":"2023020208102757800_bjs550329-bib-0010","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1093\/oxfordjournals.aje.a114877","article-title":"Cryptorchism, orchiopexy, and the risk of testicular cancer","volume":"127","author":"Strader","year":"1988","journal-title":"Am J Epidemiol"},{"key":"2023020208102757800_bjs550329-bib-0011","doi-asserted-by":"crossref","first-page":"210","DOI":"10.5489\/cuaj.1010","article-title":"Cryptorchidism and its impact on male fertility: a state of art review of current literature","volume":"5","author":"Chung","year":"2011","journal-title":"Can Urol Assoc J"},{"key":"2023020208102757800_bjs550329-bib-0012","volume-title":"UDT Conesus Statement","author":"British Association of Paediatric Urologists","year":"2011"},{"key":"2023020208102757800_bjs550329-bib-0013","volume-title":"Evaluation and Treatment of Cryptorchidism","author":"American Urological Association","year":"2014"},{"key":"2023020208102757800_bjs550329-bib-0014","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s00383-013-3429-y","article-title":"Ideal timing of orchiopexy: a systematic review","volume":"30","author":"Chan","year":"2014","journal-title":"Pediatr Surg Int"},{"key":"2023020208102757800_bjs550329-bib-0015","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.jpurol.2013.12.021","article-title":"Age at orchidopexy in the UK: has new evidence changed practice?","volume":"10","author":"Bradshaw","year":"2014","journal-title":"J Pediatr Urol"},{"key":"2023020208102757800_bjs550329-bib-0016","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1111\/j.1440-1754.2011.02202.x","article-title":"Age at orchidopexy as an indicator of the quality of regional child health services","volume":"48","author":"Bruijnen","year":"2012","journal-title":"J Pediatr Chil Health"},{"key":"2023020208102757800_bjs550329-bib-0017","first-page":"649","article-title":"The timing of surgery for undescended testis: a retrospective multicenter analysis","volume":"111","author":"Hrivatakis","year":"2014","journal-title":"Dtsch Arztebl Int"},{"key":"2023020208102757800_bjs550329-bib-0018","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.jpurol.2018.07.003","article-title":"Secular trends in the incidence and timing of surgical intervention for congenital undescended testis and surgically treated hypospadias in Ontario, Canada between 1997 and 2007","volume":"14","author":"Dave","year":"2018","journal-title":"J Pediatr Urol"},{"key":"2023020208102757800_bjs550329-bib-0019","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.jpedsurg.2007.10.041","article-title":"Orchidopexy for undescended testis in England: is it evidence based?","volume":"43","author":"McCabe","year":"2008","journal-title":"J Pediatr Surg"},{"key":"2023020208102757800_bjs550329-bib-0020","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/archdischild-2013-305225","article-title":"Undescended testis: 513 patients' characteristics, age at orchidopexy and patterns of referral","volume":"99","author":"Nah","year":"2014","journal-title":"Arch Dis Child"},{"key":"2023020208102757800_bjs550329-bib-0021","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4111\/kju.2014.55.1.69","article-title":"Reasons for delayed orchiopexies in a Korean tertiary care hospital","volume":"55","author":"Ahn","year":"2014","journal-title":"Kor J Urol"},{"key":"2023020208102757800_bjs550329-bib-0022","doi-asserted-by":"crossref","first-page":"e576","DOI":"10.1542\/peds.2010-0747","article-title":"Variations in timing of surgery among boys who underwent orchidopexy for cryptorchidism","volume":"126","author":"Kokorowski","year":"2010","journal-title":"Pediatrics"},{"key":"2023020208102757800_bjs550329-bib-0023","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1055\/s-0030-1248260","article-title":"Delayed referral despite appropriate knowledge in cryptorchidism as a cause of delayed orchidopexies in Austria","volume":"222","author":"Springer","year":"2010","journal-title":"Klin Padiatr"},{"key":"2023020208102757800_bjs550329-bib-0024","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.socscimed.2004.07.016","article-title":"Inequity and inequality in the use of health care in England: an empirical investigation","volume":"60","author":"Morris","year":"2005","journal-title":"Soc Sci Med"},{"key":"2023020208102757800_bjs550329-bib-0025","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6963-11-288","article-title":"Inequalities in utilisation of general practitioner and specialist services in 9 European countries","volume":"11","author":"Stirbu","year":"2011","journal-title":"BMC Health Serv Res"},{"key":"2023020208102757800_bjs550329-bib-0026","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1002\/hec.919","article-title":"Explaining income-related inequalities in doctor utilisation in Europe","volume":"13","author":"van Doorslaer","year":"2004","journal-title":"Health Econ"},{"key":"2023020208102757800_bjs550329-bib-0027","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/S0167-6296(00)00050-3","article-title":"Equity in the delivery of health care in Europe and the US","volume":"19","author":"van Doorslaer","year":"2000","journal-title":"J Health Econ"},{"key":"2023020208102757800_bjs550329-bib-0028","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/j.socscimed.2011.12.049","article-title":"Waiting times and socioeconomic status: evidence from England","volume":"74","author":"Laudicella","year":"2012","journal-title":"Soc Sci Med"},{"key":"2023020208102757800_bjs550329-bib-0029","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.acap.2016.07.009","article-title":"Association of universal bilirubin screening with socioeconomic disparities in newborn follow-up","volume":"17","author":"Darling","year":"2017","journal-title":"Acad Pediatr"},{"key":"2023020208102757800_bjs550329-bib-0030","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1038\/nrurol.2017.90","article-title":"Risk factors for cryptorchidism","volume":"14","author":"Gurney","year":"2017","journal-title":"Nat Rev Urol"},{"key":"2023020208102757800_bjs550329-bib-0031","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1111\/jpc.13744","article-title":"Undescended testis: what paediatricians need to know","volume":"53","author":"Hutson","year":"2017","journal-title":"J Pediatr Chil Health"},{"key":"2023020208102757800_bjs550329-bib-0032","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-005331","article-title":"Estimating the prevalence of chronic conditions in children who die in England, Scotland and Wales: a data linkage cohort study","volume":"4","author":"Hardelid","year":"2014","journal-title":"BMJ Open"},{"key":"2023020208102757800_bjs550329-bib-0033","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1136\/jech.2004.023531","article-title":"Indicators of socioeconomic position (part 1)","volume":"60","author":"Galobardes","year":"2006","journal-title":"J Epidemiol Community Health"},{"key":"2023020208102757800_bjs550329-bib-0034","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1136\/jech.2004.028092","article-title":"Indicators of socioeconomic position (part 2)","volume":"60","author":"Galobardes","year":"2006","journal-title":"J Epidemiol Community Health"},{"key":"2023020208102757800_bjs550329-bib-0035","doi-asserted-by":"crossref","first-page":"E559","DOI":"10.1503\/cmaj.101530","article-title":"Waiting for children's surgery in Canada: the Canadian Paediatric Surgical Wait Times project","volume":"183","author":"Wright","year":"2011","journal-title":"Can Med Assoc J"},{"key":"2023020208102757800_bjs550329-bib-0036","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1542\/peds.98.4.676","article-title":"Paternity after unilateral cryptorchidism: a controlled study","volume":"98","author":"Lee","year":"1996","journal-title":"Pediatrics"},{"key":"2023020208102757800_bjs550329-bib-0037","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/j.1464-410X.1989.tb05290.x","article-title":"Fertility after orchiopexy for cryptorchidism: a new approach to assessment","volume":"64","author":"Kumar","year":"1989","journal-title":"Br J Urol"},{"key":"2023020208102757800_bjs550329-bib-0038","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ijmedinf.2016.02.009","article-title":"Reasons for intentional guideline non-adherence: a systematic review","volume":"89","author":"Arts","year":"2016","journal-title":"Int J Med Informat"},{"key":"2023020208102757800_bjs550329-bib-0039","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1001\/jama.289.15.1969","article-title":"Disseminating innovations in health care","volume":"289","author":"Berwick","year":"2003","journal-title":"JAMA"}],"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs5.50329","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bjs5.50329","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bjs5.50329","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/4\/6\/1117\/49043246\/bjs550329.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/4\/6\/1117\/49043246\/bjs550329.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T18:43:35Z","timestamp":1723315415000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/4\/6\/1117\/6136127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,24]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12,2]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs5.50329","relation":{},"ISSN":["2474-9842"],"issn-type":[{"value":"2474-9842","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,7,24]]},"assertion":[{"value":"2020-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}