Access to Stereotactic radiosurgery : Identification of Existing Disparities and a Modest Proposal to Reduce Them
Bibliographic record
Abstract
Introduction Despite the abundance of literature demonstrating the safety, efficacy, and cost-effectiveness of radiosurgery, access to radiosurgery in some parts of the world remains limited. The purpose of this report is to identify disparities for stereotactic radiosurgery (SRS) and suggest possible solutions. Methods In this study, we only focus on one SRS device (Gamma Knife) for SRS availability and cost data. We utilized information from Elekta AB to identify Gamma Knife device sales and the records of the World Bank in order to calculate the ratio of Gamma Knife devices per capita. According to evidence-based data of medical oncology in the United States of America (USA), we assumed that 18% of gross domestic product (GDP) goes to healthcare spending, approximately 5% of healthcare spending goes to cancer care, and up to 30% of cancer care could be spent on radiosurgery. Results As of 2013, one Gamma Knife unit is available for approximately three million people in USA, Canada, Japan, and the Republic of Korea. In contrast, there is one Gamma Knife unit for 370 million people in Africa, 90 million people in China, 47 million people in Central and Latin America, 43 million people in Asia (excluding China, Japan, and the Republic of Korea), 36 million people in Australia, and 15 million people in Europe. According to their respective GDPs, these regions can afford to purchase the following numbers of Gamma Knife devices, respectively (assuming a unit cost of $4 million): European Union - 11,225, USA - 9,400, East Asia and Pacific region - 7,054, Latin America and Caribbean - 3,600, Middle East and North Africa - 1,039, and sub-Saharan Africa - 869. Regional medical policies in West Africa, South Africa, and East Africa could have a significant beneficial effect by making radiosurgery accessible to people in these resource-limited regions. Conclusions Stereotactic devices per patient population ratios and GKRS device cost relative to GDP vary tremendously. These factors likely affect patient access to stereotactic radiosurgery. Collaboration of regional medical groups, institutions providing radiosurgical care, and both government and non-governmental organizations could help reduce these limitations to care and improve access to SRS, particularly in resource constrained countries.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".