Trends and levels of the global, regional, and national burden of appendicitis between 1990 and 2021: findings from the Global Burden of Disease Study 2021

Han H. Letourneau I.D. Abate Y.H. Abdelmasseh M. Abu-Gharbieh E. Adane T.D. Ahinkorah B.O. Ahmad A. Ahmadi A. Ahmed A. Alhalaiqa F.N. Al-Sabah S.K. Al-Worafi Y.M. Amu H. Andrei C.L. Anoushiravani A. Arabloo J. Aravkin A.Y. Ashraf T. Azadnajafabad S. Baghcheghi N. Bagherieh S. Bantie B.B. Bardhan M. Basile G. Bayleyegn N.S. Behnoush A.H. Bekele A. Bhojaraja V.S. Bijani A. Biondi A. Burkart K. Chu D.-T. Chukwu I.S. Cruz-Martins N. Dai X. Demessa B.H. Dhali A. Diaz D. Do T.C. Dodangeh M. Dongarwar D. Dsouza H.L. Ekholuenetale M. Ekundayo T.C. Sayed I.E. Elhadi M. Fagbamigbe A.F. Fakhradiyev I.R. Ferrara P. Fetensa G. Fischer F. Gebrehiwot M. Getachew M. Golechha M. Gupta V.K. Habib J.R. Hadi N.R. Haep N. Haile T.G. Hamilton E.B. Hasan I. Hasani H. Hassanzadeh S. Haubold J. Hay S.I. Hayat K. Ilesanmi O.S. Inamdar S. Iwu C.C.D. Iyasu A.N. Jayarajah U. Jayaram S. Jokar M. Jomehzadeh N. Joseph A. Joseph N. Joshua C.E. Kabir A. Kandel H. Kauppila J.H. Bohan P.M.K. Khajuria H. Khan M. Khatatbeh H. Kim M.S. Kisa A. Kompani F. Koohestani H.R. Kumar R. Le T.T.T. Lee M. Lee S.W. Li M.-C. Lim S.S. Lo C.-H. Lunevicius R. Malhotra K. Maugeri A. Mediratta R.P. Meretoja T.J. Mestrovic T. Mirza-Aghazadeh-Attari M. Mohamed N.S. Mokdad A.H. Monasta L. Moni M.A. Moradi M. Mougin V. Mukoro G.D. Murillo-Zamora E. Murray C.J.L. Naimzada M.D. Najmuldeen H.H.R. Natto Z.S. Negoi I. Nguyen H.Q. Nikolouzakis T.K. Olufadewa I.I. Padubidri J.R. Pandey A. Parikh R.R. Pham H.T. Pollok R.C.G. Rahimi M. Rahimi-Movaghar V. Rahman M. Rahmani S. Rashidi M.-M. Rawaf S. Rickard J. Rouientan H. Roy S. Saddik B.A. Saeed U. Saleh M.A. Salehi S. Samy A.M. Sanabria J. Sankararaman S. Schumacher A.E. Senthilkumaran S. Shah P.A. Shool S. Sibhat M.M. Sidamo N.B. Singh J.A. Socea B. Solomon Y. Sreeram S. Tabatabaei S.M. Tan K.-K. Tavangar S.M. Tefera Y.M. Thomas N.K. Ticoalu J.H.V. Tsegay G.M. Tsegaye D. Ullah S. Usman A.N. Valizadeh R. Veroux M. Verras G.-I. Vos T. Wang M. Wang S. Wickramasinghe D.P. Yahya G. Zare I. Zarrintan A. Zhang Z.-J. Dirac M.A.
September 2024 Elsevier Ltd

The Lancet Gastroenterology and Hepatology
2024 #9 Issue 9 825 - 858 pp.

Background: Appendicitis is a common surgical emergency that poses a large clinical and economic burden. Understanding the global burden of appendicitis is crucial for evaluating unmet needs and implementing and scaling up intervention services to reduce adverse health outcomes. This study aims to provide a comprehensive assessment of the global, regional, and national burden of appendicitis, by age and sex, from 1990 to 2021. Methods: Vital registration and verbal autopsy data, the Cause of Death Ensemble model (CODEm), and demographic estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) were used to estimate cause-specific mortality rates (CSMRs) for appendicitis. Incidence data were extracted from insurance claims and inpatient discharge sources and analysed with disease modelling meta-regression, version 2.1 (DisMod-MR 2.1). Years of life lost (YLLs) were estimated by combining death counts with standard life expectancy at the age of death. Years lived with disability (YLDs) were estimated by multiplying incidence estimates by an average disease duration of 2 weeks and a disability weight for abdominal pain. YLLs and YLDs were summed to estimate disability-adjusted life-years (DALYs). Findings: In 2021, the global age-standardised mortality rate of appendicitis was 0·358 (95% uncertainty interval [UI] 0·311–0·414) per 100 000. Mortality rates ranged from 1·01 (0·895–1·13) per 100 000 in central Latin America to 0·054 (0·0464–0·0617) per 100 000 in high-income Asia Pacific. The global age-standardised incidence rate of appendicitis in 2021 was 214 (174–274) per 100 000, corresponding to 17 million (13·8–21·6) new cases. The incidence rate was the highest in high-income Asia Pacific, at 364 (286–475) per 100 000 and the lowest in western sub-Saharan Africa, at 81·4 (63·9–109) per 100 000. The global age-standardised rates of mortality, incidence, YLLs, YLDs, and DALYs due to appendicitis decreased steadily between 1990 and 2021, with the largest reduction in mortality and YLL rates. The global annualised rate of decline in the DALY rate was greatest in children younger than the age of 10 years. Although mortality rates due to appendicitis decreased in all regions, there were large regional variations in the temporal trend in incidence. Although the global age-standardised incidence rate of appendicitis has steadily decreased between 1990 and 2021, almost half of GBD regions saw an increase of greater than 10% in their age-standardised incidence rates. Interpretation: Slow but promising progress has been observed in reducing the overall burden of appendicitis in all regions. However, there are important geographical variations in appendicitis incidence and mortality, and the relationship between these measures suggests that many people still do not have access to quality health care. As the incidence of appendicitis is rising in many parts of the world, countries should prepare their health-care infrastructure for timely, high-quality diagnosis and treatment. Given the risk that improved diagnosis may counterintuitively drive apparent rising trends in incidence, these efforts should be coupled with improved data collection, which will also be crucial for understanding trends and developing targeted interventions. Funding: Bill and Melinda Gates Foundation.

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Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
Department of Applied Mathematics, University of Washington, Seattle, WA, United States
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
Department of Family Medicine, University of Washington, Seattle, WA, United States
Department of Clinical Governance and Quality Improvement, Aleta Wondo Hospital, Aleta Wondo, Ethiopia
Department of Surgery, Marshall University, Huntington, WV, United States
Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
College of Medicine, University of Sharjah, United Arab Emirates
Department of Biopharmaceutics and Clinical Pharmacy, The University of Jordan, Amman, Jordan
Department of Clinical and Psychosocial Epidemiology, University of Groningen, Groningen, Netherlands
School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
Department of Medical Biochemistry, Shaqra University, Shaqra, Saudi Arabia
Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Institute of Institute for Health Metrics and Evaluation, United States
College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
School of Public Health, Wuhan University, Wuhan, China
Department of Surgery, General University Hospital of Patras, Patras, Greece
Department of Nursing, Addis Ababa University, Addis Ababa, Ethiopia
Department of Public Health, Dire Dawa University, Dire Dawa, Ethiopia
Department of Pathology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
Department of Biopharmaceutics and Clinical Pharmacy, The University of Jordan, Amman, Jordan
Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
Faculty of Public Health, Universitas Sam Ratulangi (Sam Ratulangi University), Manado, Indonesia
Department of Gastroenterology, St Lukes Hospital, Pathanamthitta, India
Department of Cells and Tissues, Molecular Biology Institute of Barcelona, Barcelona, Spain
Department of Surgery, National University of Singapore, Singapore, Singapore
Clinial Research Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran
Research and Development Department, Sina Medical Biochemistry Technologies, Shiraz, Iran
Department of Gastroenterology, Shanghai Jiao Tong University Affiliated Sixth Peoples Hospital, Shanghai, China
Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran
Institute of Endemic Diseases, University of Khartoum, Sudan
Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
College of Nursing, Qatar University, Doha, Qatar
Psychological Sciences Association, Amman, Jordan
Department of Surgery, Kuwait University, Kuwait, Kuwait
Jaber Al Ahmad Al Sabah Hospital, Ministry of Health, Kuwait
Department of Medical Sciences, Azal University for Human Development, Sanaa, Yemen
Department of Clinical Sciences, University of Science and Technology of Fujairah, Fujairah, United Arab Emirates
Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana
Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Childrens Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
Health Management and Economics Research Center
School of Medicine, Tehran, Iran
Department of Ophthalmology, Tehran, Iran
Minimally Invasive Surgery Research Center, Tehran, Iran
Iran University of Medical Sciences, Tehran, Iran
University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
Department of Nursing, Saveh University of Medical Sciences, Saveh, Iran
Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
School of Medicine Isfahan University of Medical Sciences, Isfahan, Iran
Department of Comprehensive Nursing, Debre Tabor University, Debre Tabor, Ethiopia
Miami Cancer Institute, Baptist Health South Florida, Miami, FL, United States
Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
Department of Medical and Surgical Sciences and Advanced Technologies Gf Ingrassia, University of Catania, Catania, Italy
Department of Surgery, Jimma University, Jimma, Ethiopia
Non-Communicable Diseases Research Center (NCDRC) Tehran, Iran, Iran
Department of Medical Anatomy, Arba Minch University, Arba Minch, Ethiopia
School of Public Health, Arba Minch University, Arba Minch, Ethiopia
Department of Anatomy, Royal College of Surgeons in Ireland Medical, University of Bahrain, Busaiteen, Bahrain
Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
Center for Biomedicine and Community Health, Vietnam National University Hanoi (VNUIS) Hanoi, Viet Nam
Department of Paediatric Surgery, Federal Medical Centre, Umuahia, Nigeria
Department of Diagnostic and Therapeutic Technologies, Coop. de Ensino Sup. Politec. e Univ. (Polytech. and Univ. Higher Educ. Coop.), Vila Nova de Famalicao, Portugal
Institute for Research and Innovation in Health (I3S), University of Porto, Porto, Portugal
Jimma University, USAID-JSI Digital Health Activity, Addis Ababa, Ethiopia
Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, United Kingdom
Faculty of Science, National Autonomous University of Mexico, Mexico City, Mexico
Department of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
School of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
Health Science Center, University of Texas, Houston, TX, United States
Manipal Academy of Higher Education, Manipal Academy of Higher Education, Manipal, India
Department of Pathology, Manipal Academy of Higher Education, Manipal, India
Department of Forensic Medicine and Toxicology, Kasturba Medical College Mangalore, Mangalore, India
Faculty of Science and Health, University of Portsmouth, Hampshire, United Kingdom
Department of Microbiology, University of Medical Sciences, Ondo, Nigeria
Biomedical Informatics and Medical Statistics Department, Alexandria University, Alexandria, Egypt
Faculty of Medicine, University of Tripoli, Tripoli, Libya
Houston Methodist Hospital, Houston, TX, United States
Department of Epidemiology and Medical Statistics, Faculty of Public Health University of Ibadan, Ibadan, Nigeria
Research Centre for Healthcare and Community, Coventry University, Coventry, United Kingdom
Kazakh National Medical University, Scientific and Technological Park, Almaty, Kazakhstan
Research Center on Public Health, University of Milan Bicocca, Monza, Italy
Department of Nursing, Wollega University, Nekemte, Ethiopia
Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
Department of Environmental Health, Wollo University, Dessie, Ethiopia
Department of Emergency and Critical Care Medicine, Haramaya University, Harar, Ethiopia
Department of Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
Department of Surgery, University of Maryland, New York, NY, United States
Department of Clinical Pharmacology and Medicine, University of Kufa, Najaf, Iraq
Department of Surgery, Charité Medical University Berlin, Berlin, Germany
Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany
Department of Nursing, Aksum University, Aksum, Ethiopia
Department of Pharmaceutical Technology, University of Dhaka, Dhaka, Bangladesh
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
Institute of Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
Africa Centre for Disease Control and Prevention, University of Ibadan, Abuja, Nigeria
Department of Community Medicine, University College Hospital, Ibadan, Nigeria
Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
Department of Surgery, Colombo, Sri Lanka
Department of Surgery, National Hospital, Colombo, Sri Lanka
Department of Biochemistry, Government Medical College, Mysuru, India
Zoonoses Research Center, Islamic Azad University, Karaj, Iran
Jahrom University of Medical Sciences, Ahvaz, Iran
Department of Microbiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Microbiology, Abadan School of Medical Sciences, Abadan, Iran
Department of Gastroenterology and Hepatology, Stanford University, Stanford, CA, United States
Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
Department of Economics, National Open University, Benin City, Nigeria
Save Sight Institute, University of Sydney, Sydney, NSW, Australia
Sydney Eye Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia
Surgery Research Unit, University of Oulu, Oulu, Finland
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
Department of Surgery, Brooke Army Medical Center, Seattle, WA, United States
Amity Institute of Forensic Sciences, Amity University, Noida, India
Department of Epidemiology, Jazan University, Jazan, Saudi Arabia
Faculty of Nursing, Jerash University, Jerash, Jordan
Broad Institute of Mit and Harvard, Cambridge, MA, United States
School of Health Sciences, Kristiania University College, Oslo, Norway
Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, United States
College of Public Health and Health Informatics, University of Hail, Hail, Saudi Arabia
University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
Department of Medical Science, Ajou University School of Medicine, Suwon, South Korea
Department of Precision Medicine, Sungkyunkwan University, Suwon-si, South Korea
Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
Department of Internal Medicine, Kirk Kerkorian School of Medicine at Unlv, Las Vegas, NV, United States
Department of Emergency General and Trauma Surgery, Liverpool University Hospitals Nhs Foundation Trust, Liverpool, United Kingdom
Department of Surgery, University of Liverpool, Liverpool, United Kingdom
Rama Medical College Hospital and Research Centre, Uttar Pradesh, India
Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
School of Public Health, University of Adelaide, Adelaide, SA, Australia
Division of Pediatric Hospital Medicine, Stanford University, Palo Alto, CA, United States
Division of Breast Surgery, Helsinki University Hospital, Helsinki, Finland
University of Helsinki, Helsinki, Finland
University Centre Varazdin, University North, Varazdin, Croatia
Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Social Determinants of Health Center, Urmia, Iran
Urmia University of Medical Sciences, Urmia, Iran
Sirius Training and Research Centre, Molecular Biology Unit, Sudan
Sirius Training and Research Centre, Bio-Statistical and Molecular Biology Department, Khartoum, Sudan
Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
Charles Sturt University, Bathurst, NSW, Australia
Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Mexico
Universidad de Colima, Postgraduate in Medical Sciences, Colima, Mexico
Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russian Federation
Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russian Federation
Department of Medical Laboratory Analysis, Cihan University Sulaymaniya, Sulaymaniyah, Iraq
Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
Department of Health Policy and Oral Epidemiology, Harvard University, Boston, MA, United States
Department of General Surgery, Emergency University Hospital Bucharest, Romania, Bucharest, Romania
Cardiovascular Research Department, Methodist Hospital, Merrillville, IN, United States
Department of General Surgery, University Hospital of Heraklion, Greece, Heraklion, Greece
Laboratory of Toxicology, University of Crete, Greece, Heraklion, Greece
Slum and Rural Health Initiative Research Academy, Slum and Rural Health Initiative, Ibadan, Nigeria
Department of Microbiology and Immunology, Zagazig University, Zagazig, Egypt
Research Department, Kathmandu, Nepal
Department of Nursing, Dire Dawa University, Dire Dawa, Ethiopia
Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States
Department of Surgery, University of Minnesota, Minneapolis, MN, United States
Institute of Infection and Immunity, University of London, St Georges, United Kingdom
Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
Academic Public Health England, Public Health England, London, United Kingdom
Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
Department of Epidemiology, Florida International University, Miami, FL, United States
School of Population Health, University of New South Wales, Sydney, NSW, Australia
Clinical and Biomedical Research Center, Foundation University, Islamabad, Pakistan
International Center of Medical Sciences Research (ICMSR) Islamabad, Pakistan
Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
Medical Ain Shams Research Institute (MASRI), Ain Shams University, Department of Entomology, Cairo, Egypt
Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, United States
Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States
Department of Pediatrics, University Hospitals Rainbow Babies and Childrens Hospital, Cleveland, OH, United States
Emergency Department, Manian Medical Centre, Erode, India
Department of Microbiology, Rajiv Gandhi University of Health Sciences, Bangalore, India
Department of Pediatrics and Child Health Nursing, Dilla University, Dilla, Ethiopia
School of Medicine, University of Alabama at Birmingham, Houston, TX, United States
Us Department of Veterans Affairs (VA) Houston, Medicine Service, TX, United States
Department of Surgery, Sf. Pantelimon Emergency Clinical Hospital Bucharest, Bucharest, Romania
Department of Forensic Medicine and Toxicology, Kasturba Medical College, Mangalore, India

Institute for Health Metrics and Evaluation
Department of Applied Mathematics
Department of Health Metrics Sciences
Department of Family Medicine
Department of Clinical Governance and Quality Improvement
Department of Surgery
Clinical Sciences Department
College of Medicine
Department of Biopharmaceutics and Clinical Pharmacy
Department of Clinical and Psychosocial Epidemiology
School of Public Health
Department of Medical Biochemistry
Department of Epidemiology and Biostatistics
Department of Epidemiology
School of Medicine
Social Determinants of Health Research Center
Urology and Nephrology Research Center
Department of Surgery
Institute of Institute for Health Metrics and Evaluation
College of Medicine and Veterinary Medicine
Emergency Department
School of Public Health
Department of Surgery
Department of Nursing
Department of Public Health
Department of Pathology
Department of Biopharmaceutics and Clinical Pharmacy
Department of Biochemistry and Molecular Biology
Department of Nursing
Faculty of Public Health
Department of Gastroenterology
Department of Cells and Tissues
Department of Surgery
Clinial Research Development Unit
Research and Development Department
Department of Gastroenterology
Department of Medical Informatics
Institute of Endemic Diseases
Swiss Tropical and Public Health Institute
College of Nursing
Psychological Sciences Association
Department of Surgery
Jaber Al Ahmad Al Sabah Hospital
Department of Medical Sciences
Department of Clinical Sciences
Department of Population and Behavioural Sciences
Department of Cardiology
Department of General Surgery
Digestive Diseases Research Institute
School of Medicine
Childrens Medical Center
Sina Trauma and Surgery Research Center
Non-communicable Diseases Research Center
Department of Pathology
Health Management and Economics Research Center
School of Medicine
Department of Ophthalmology
Minimally Invasive Surgery Research Center
Iran University of Medical Sciences
University Institute of Radiological Sciences and Medical Imaging Technology
Leeds Institute of Rheumatic and Musculoskeletal Medicine
Department of Nursing
Social Determinants of Health Research Center
School of Medicine Isfahan University of Medical Sciences
Department of Comprehensive Nursing
Miami Cancer Institute
Department of General Surgery and Medical-Surgical Specialties
Department of Medical and Surgical Sciences and Advanced Technologies Gf Ingrassia
Department of Surgery
Non-Communicable Diseases Research Center (NCDRC) Tehran
Department of Medical Anatomy
School of Public Health
Department of Anatomy
Social Determinants of Health Research Center
Center for Biomedicine and Community Health
Department of Paediatric Surgery
Department of Diagnostic and Therapeutic Technologies
Institute for Research and Innovation in Health (I3S)
Jimma University
Sheffield Teaching Hospitals Nhs Foundation Trust
Faculty of Science
Department of Medicine
School of Medicine
Health Science Center
Manipal Academy of Higher Education
Department of Pathology
Department of Forensic Medicine and Toxicology
Faculty of Science and Health
Department of Microbiology
Biomedical Informatics and Medical Statistics Department
Faculty of Medicine
Houston Methodist Hospital
Department of Epidemiology and Medical Statistics
Research Centre for Healthcare and Community
Kazakh National Medical University
Research Center on Public Health
Department of Nursing
Institute of Public Health
Department of Environmental Health
Department of Emergency and Critical Care Medicine
Department of Health Systems and Policy Research
Faculty of Medicine Health and Human Sciences
Department of Surgery
Department of Clinical Pharmacology and Medicine
Department of Surgery
Clinician Scientist Program
Department of Nursing
Department of Pharmaceutical Technology
Department of Diagnostic and Interventional Radiology and Neuroradiology
Institute of Artificial Intelligence in Medicine
Institute of Pharmaceutical Sciences
Department of Pharmacy Administration and Clinical Pharmacy
Africa Centre for Disease Control and Prevention
Department of Community Medicine
Division of Gastroenterology and Hepatology
School of Health Systems and Public Health
Department of Surgery
Department of Surgery
Department of Biochemistry
Zoonoses Research Center
Jahrom University of Medical Sciences
Department of Microbiology
Department of Microbiology
Department of Gastroenterology and Hepatology
Department of Community Medicine
Department of Economics
Save Sight Institute
Sydney Eye Hospital
Surgery Research Unit
Department of Molecular Medicine and Surgery
Department of Surgery
Amity Institute of Forensic Sciences
Department of Epidemiology
Faculty of Nursing
Broad Institute of Mit and Harvard
School of Health Sciences
Department of International Health and Sustainable Development
College of Public Health and Health Informatics
University of Medicine and Pharmacy at Ho Chi Minh City
Department of Medical Science
Department of Precision Medicine
Department of Health Promotion and Health Education
Department of Internal Medicine
Department of Emergency General and Trauma Surgery
Department of Surgery
Rama Medical College Hospital and Research Centre
Institute of Applied Health Research
School of Public Health
Division of Pediatric Hospital Medicine
Division of Breast Surgery
University of Helsinki
University Centre Varazdin
Department of Radiology
Cardiovascular Research Center
Social Determinants of Health Center
Urmia University of Medical Sciences
Sirius Training and Research Centre
Sirius Training and Research Centre
Clinical Epidemiology and Public Health Research Unit
Charles Sturt University
Department of Surgery
Clinical Epidemiology Research Unit
Universidad de Colima
Laboratory of Public Health Indicators Analysis and Health Digitalization
Experimental Surgery and Oncology Laboratory
Department of Medical Laboratory Analysis
Department of Dental Public Health
Department of Health Policy and Oral Epidemiology
Department of General Surgery
Cardiovascular Research Department
Department of General Surgery
Laboratory of Toxicology
Slum and Rural Health Initiative Research Academy
Department of Microbiology and Immunology
Research Department
Department of Nursing
Department of Epidemiology and Community Health
Department of Surgery
Institute of Infection and Immunity
Department of Population Science and Human Resource Development
Department of Primary Care and Public Health
Academic Public Health England
Department of Surgery
Department of Epidemiology
School of Population Health
Clinical and Biomedical Research Center
International Center of Medical Sciences Research (ICMSR) Islamabad
Faculty of Pharmacy
Mark and Mary Stevens Neuroimaging and Informatics Institute
Medical Ain Shams Research Institute (MASRI)
Department of Nutrition and Preventive Medicine
Department of Pediatrics
Department of Pediatrics
Emergency Department
Department of Microbiology
Department of Pediatrics and Child Health Nursing
School of Medicine
Us Department of Veterans Affairs (VA) Houston
Department of Surgery
Department of Forensic Medicine and Toxicology

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