ArticlePediatrics2015
Regional variation in antenatal corticosteroid use: a network-level quality improvement study.
Article in Pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
15 citing papers in PubMed.
- Obstacles to Optimal Antenatal Corticosteroid Administration to Eligible Patients.American journal of perinatology · 2024Observational
- The variation of antenatal corticosteroids administration for the singleton preterm birth in China, 2017 to 2018.BMC pediatrics · 2022Observational
- Improving birth certificate data accuracy in Alabama.Health science reports · 2022Article
- The center-effect on outcomes for infants born at less than 25 weeks.Seminars in perinatology · 2022Review
- Survival Without Major Morbidity Among Very Low Birth Weight Infants in California.Pediatrics · 2020Article
- Development and use of an adjusted nurse staffing metric in the neonatal intensive care unit.Health services research · 2020Article
- Regional and Racial-Ethnic Differences in Perinatal Interventions Among Periviable Births.Obstetrics and gynecology · 2020Article
- Disparities in the use of antenatal corticosteroids among women with hypertension in North Carolina.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- An evaluation of the benefits and harms of antenatal corticosteroid treatment for women at risk of imminent preterm birth or prior to elective Caesarean-section: Study protocol for an individual participant data meta-analysis.Wellcome open research · 2020Article
- Racial/Ethnic Disparity in NICU Quality of Care Delivery.Pediatrics · 2017Observational
- Variation in quality report viewing by providers and correlation with NICU quality metrics.Journal of perinatology : official journal of the California Perinatal Association · 2017Observational
- Use of evidence based practices to improve survival without severe morbidity for very preterm infants: results from the EPICE population based cohort.BMJ (Clinical research ed.) · 2016Observational
- The Association of Level of Care With NICU Quality.Pediatrics · 2016Article
- Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
BACKGROUND AND
objectivesExamination of regional care patterns in antenatal corticosteroid use (ACU) rates may be salient for the development of targeted interventions. Our objective was to assess network-level variation using California perinatal care regions as a proxy. We hypothesized that (1) significant variation in ACU exists within and between California perinatal care regions, and (2) lower performing regions exhibit greater NICU-level variability in ACU than higher performing regions.
methodsWe undertook cross-sectional analysis of 33,610 very low birth weight infants cared for at 120 hospitals in 11 California perinatal care regions from 2005 to 2011. We computed risk-adjusted median ACU rates and interquartile ranges (IQR) for each perinatal care region. The degree of variation was assessed using hierarchical multivariate regression analysis with NICU as a random effect and region as a fixed effect.
resultsFrom 2005 to 2011, mean ACU rates across California increased from 82% to 87.9%. Regional median (IQR) ACU rates ranged from 68.4% (24.3) to 92.9% (4.8). We found significant variation in ACU rates among regions (P < .0001). Compared with Level IV NICUs, care in a lower level of care was a strongly significant predictor of lower odds of receiving antenatal corticosteroids in a multilevel model (Level III, 0.65 [0.45-0.95]; Level II, 0.39 [0.24-0.64]; P < .001). Regions with lower performance in ACU exhibited greater variability in performance.
conclusionsWe found significant variation in ACU rates among California perinatal regions. Regional quality improvement approaches may offer a new avenue to spread best practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.