SynthesisBMJ (Clinical research ed.)2011
A comparison of clinical officers with medical doctors on outcomes of caesarean section in the developing world: meta-analysis of controlled studies.
Synthesis in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Assessing the impact of anaesthetic and surgical task-shifting globally: a systematic literature review.Health policy and planning · 2023Pooled it
- Delivery arrangements for health systems in low-income countries: an overview of systematic reviews.The Cochrane database of systematic reviews · 2017Pooled it
- Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women.Diabetologia · 2016Pooled it
- Innovative approaches for improving maternal and newborn health--A landscape analysis.BMC pregnancy and childbirth · 2015Pooled it
- Thyroid function in early pregnancy following frozen embryo transfer: analysis from a randomized controlled trial.Journal of assisted reproduction and genetics · 2026Trial
- Task-sharing spinal anaesthesia care in three rural Indian hospitals: a non-inferiority randomised controlled clinical trial.BMJ global health · 2024Trial
- Outcomes After Elective Inguinal Hernia Repair Performed by Associate Clinicians vs Medical Doctors in Sierra Leone: A Randomized Clinical Trial.JAMA network open · 2021Trial
- The contribution of non-physician clinicians to the provision of surgery in rural Zambia-a randomised controlled trial.Human resources for health · 2019Trial
- The impact of training non-physician clinicians in Malawi on maternal and perinatal mortality: a cluster randomised controlled evaluation of the enhancing training and appropriate technologies for mothers and babies in Africa (ETATMBA) project.BMC pregnancy and childbirth · 2012Trial
- Article
- Physician assistants/associates in psychiatry: a workforce analysis.Human resources for health · 2024Article
- [Perceived utility of the inclusion of physician assistants in the surgical process quality and continuing education in Germany : Results of an interprofessional online survey].Unfallchirurgie (Heidelberg, Germany) · 2024Article
- Understanding the scope of practice of physician associate/physician associate comparable professions using the World Health Organization global competency and outcomes framework for universal health coverage.Human resources for health · 2023Article
- Article
- Pathways to effective surgical coverage in a lower-middle-income country: A multiple methods study of the family physician-led generalist surgical team in rural Nepal.PLOS global public health · 2023Article
- The impact of training on self-reported performance in reproductive, maternal, and newborn health service delivery among healthcare workers in Tanzania: a baseline- and endline-survey.Reproductive health · 2022Article
- Assessing competence of mid-level providers delivering primary health care in India: a clinical vignette-based study in Chhattisgarh state.Human resources for health · 2022Article
- Clinical associates and access to healthcare in the Eastern Cape province of South Africa.African journal of primary health care & family medicine · 2022Article
- Resource availability and barriers to delivering quality care for newborns in hospitals in the southern region of Malawi: A multisite observational study.PLOS global public health · 2022Article
- Detection and prevalence of depression among adult type 2 diabetes mellitus patients attending non-communicable diseases clinics in Lilongwe, Malawi.International journal of mental health systems · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo review the effectiveness and safety of clinical officers (healthcare providers trained to perform tasks usually undertaken by doctors) carrying out caesarean section in developing countries compared with doctors.
designSystematic review with meta-analysis. DATA SOURCES: Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, BioMed Central, the Reproductive Health Library, and the Science Citation Index (inception-2010) without language restriction. STUDY SELECTION: Controlled studies. DATA EXTRACTION: Information was extracted from each selected article on study characteristics, quality, and outcome data. Two independent reviewers extracted data.
resultsSix non-randomised controlled studies (16,018 women) evaluated the effectiveness of clinical officers carrying out caesarean section. Meta-analysis found no significant differences between the clinical officers and doctors for maternal death (odds ratio 1.46, 95% confidence interval 0.78 to 2.75; P=0.24) or for perinatal death (1.31, 0.87 to 1.95; P=0.19). The results were heterogeneous, with some studies reporting a higher incidence of both outcomes with clinical officers. Clinical officers were associated with a higher incidence of wound infection (1.58, 1.01 to 2.47; P=0.05) and wound dehiscence (1.89, 1.21 to 2.95; P=0.005). Two studies accounted for confounding factors.
conclusionClinical officers and doctors did not differ significantly in key outcomes for caesarean section, but the conclusions are tentative owing to the non-randomised nature of the studies. The increase in wound infection and dehiscence may highlight a particular training need for clinical officers.
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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 OpenQuestion graph.