Evidence map›Paper›PMID 33631411›Full record

ArticleMidwifery2021

Midwife-performed checklist and ultrasound to identify obstetric conditions at labour triage in Uganda: A quasi-experimental study.

Jude Mulowooza, Nicole Santos, Nathan Isabirye, Innocent Inhensiko, Nancy L Sloan, Sachita Shah, Elizabeth Butrick, Peter Waiswa, Dilys Walker

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Midwifery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.7field-weighted citation impact, top 8% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Jude MulowoozaMakerere University, School of Public Health, P.O Box 7072, Kampala, Uganda.
Nicole SantosInstitute for Global Health Sciences, University of California San Francisco, 550 16th Street, 3rd floor, San Francisco, CA 94158 United States. Electronic address: Nicole.Santos@ucsf.edu.
Nathan IsabiryeMakerere University, School of Public Health, P.O Box 7072, Kampala, Uganda.
Innocent InhensikoMakerere University, School of Public Health, P.O Box 7072, Kampala, Uganda.
Nancy L SloanInstitute for Global Health Sciences, University of California San Francisco, 550 16th Street, 3rd floor, San Francisco, CA 94158 United States.
Sachita ShahDepartment of Emergency Medicine, University of Washington, 325 9th Ave., Seattle, WA 98104 United States.
Elizabeth ButrickInstitute for Global Health Sciences, University of California San Francisco, 550 16th Street, 3rd floor, San Francisco, CA 94158 United States.
Peter WaiswaMakerere University, School of Public Health, P.O Box 7072, Kampala, Uganda; Global Health Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Dilys WalkerInstitute for Global Health Sciences, University of California San Francisco, 550 16th Street, 3rd floor, San Francisco, CA 94158 United States; Department of Obstetrics, Gynaecology and Reproductive Sciences, University of California San Francisco, United States.
University of California, San Francisco · USMakerere University · UGKarolinska Institutet · SEUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to evaluate the effect of a midwife-performed checklist and limited obstetric ultrasound on sensitivity and positive predictive value for a composite outcome comprising multiple gestation, placenta praevia, oligohydramnios, preterm birth, malpresentation, abnormal foetal heart rate.

designQuasi-experimental pre-post intervention study.

settingMaternity unit at a district hospital in Eastern Uganda.

interventionsInterventions were implemented in a phased approach: standardised labour triage documentation (Phase 1), a triage checklist (Phase 2), and checklist plus limited obstetric ultrasound (Phase 3).

participantsConsenting women presenting to labour triage for admission after 28 weeks of gestation between February 2018 and June 2019 were eligible. Women not in labour or those requiring immediate care were excluded. 3,865 women and 3,937 newborns with similar sample sizes per phase were included in the analysis. MEASUREMENT AND

findingsOutcome data after birth were used to determine true presence of a complication, while intake and checklist data were used to inform diagnosis before birth. Compared to Phase 1, Phase 2 and 3 interventions improved sensitivity (Phase 1: 47%, Phase 2: 68.8%, Phase 3: 73.5%; p ≤ 0.001) and reduced positive predictive value (65.9%, 55%, 48.7%, p ≤ 0.001) for the composite outcome. No phase differences in adverse maternal or foetal outcomes were observed.

conclusionBoth a triage checklist and a checklist plus limited obstetric ultrasound improved accurate identification of cases with some increase in false positive diagnosis. These interventions may be beneficial in a resource-limited maternity triage setting to improve midwives' diagnoses and clinical decision-making.

Indexed as

ChecklistMidwiferyPremature BirthCesarean SectionFemaleHumansInfant, NewbornMalePredictive Value of TestsPregnancyTriageUgandaUltrasonography, PrenatalChecklistLabour triageMidwifeObstetric ultrasound

Identifiers

PMID33631411
PMCPMC7988503
OpenAlexW3131297283

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.