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Estimating the burden of underdiagnosis within England: A modelling study of linked primary care data
Olga Anosova, Anna Head, Brendan Collins, Alexandros Alexiou, Konstantinos Daras, Matt Sutton, Richard Cookson, Laura Anselmi et al.. PLoS ONE, 2025-01-15
Topic: Risk, prevention and care in population studies
Levels of underdiagnosis varied between 16% for stroke and 69% for prostate cancer in 2018. For all diseases, the level of underdiagnosis declined over time. Underdiagnosis was not consistently concentrated in areas with high deprivation. For depression/anxiety and stroke, underdiagnosis was estimated to be higher in less deprived CCGs, whilst for CHD and T2DM, it was estimated to be higher in more deprived CCGs, with no apparent relationships for other conditions. We found no uniform spatial patterns of underdiagnosis across all diseases, and the relationship between age, deprivation and the probability of being undiagnosed varied greatly between diseases. Our findings suggest that underdiagnosis is not consistently concentrated in areas with high deprivation, nor is there a uniform spatial underdiagnosis pattern across diseases. This novel method for estimating the burden of underdiagnosis within England depends on the quality of routinely collected data, but it suggests that more research is needed to understand the key drivers of underdiagnosis.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Anosova, O., Head, A., Collins, B., Alexiou, A., Daras, K., Sutton, M., et al. (2025). Estimating the burden of underdiagnosis within England: A modelling study of linked primary care data. PLoS ONE. https://doi.org/10.1371/journal.pone.0313877
Vancouver
Anosova O, Head A, Collins B, Alexiou A, Daras K, Sutton M, et al. Estimating the burden of underdiagnosis within England: A modelling study of linked primary care data. PLoS ONE. 2025. doi:10.1371/journal.pone.0313877. PMID: 39813200.
BibTeX
@article{anosova2025-39813200,
author = {Anosova, Olga and Head, Anna and Collins, Brendan and Alexiou, Alexandros and Daras, Konstantinos and Sutton, Matt and Cookson, Richard and Anselmi, Laura and others},
title = {{Estimating the burden of underdiagnosis within England: A modelling study of linked primary care data}},
journal = {PLoS ONE},
year = {2025},
doi = {10.1371/journal.pone.0313877},
pmid = {39813200},
url = {https://doi.org/10.1371/journal.pone.0313877}
}
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Key findings
- Levels of underdiagnosis varied between 16% for stroke and 69% for prostate cancer in 2018.
- For all diseases, the level of underdiagnosis declined over time.
- Underdiagnosis was not consistently concentrated in areas with high deprivation.
- For depression/anxiety and stroke, underdiagnosis was estimated to be higher in less deprived CCGs, whilst for CHD and T2DM, it was estimated to be higher in more deprived CCGs, with no apparent relationships for other conditions.
- We found no uniform spatial patterns of underdiagnosis across all diseases, and the relationship between age, deprivation and the probability of being undiagnosed varied greatly between diseases.
Why it matters
This modelling study estimated how often several diseases go undiagnosed in England and where underdiagnosis occurs. It does not test any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (PLoS ONE) |
| Journal's citation record | 4 / 4 | PLoS ONE: journal h-index 594 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 8 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 9.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Chris Kypridemos: h-index 23 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Manchester: institution h-index 1,304 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39813200) |
| Free to read | 2 / 2 | Free to read |
| Total | 42 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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