Evidence map›Paper›PMID 33753429›Full record

ReviewBMJ open2021

Conversations about FGM in primary care: a realist review on how, why and under what circumstances FGM is discussed in general practice consultations.

Sharon Dixon, Claire Duddy, Gabrielle Harrison, Chrysanthi Papoutsi, Sue Ziebland, Frances Griffiths

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.3field-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, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Women's health and primary care: time to get it right for the life course.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021
    Article
  7. Review
  8. Article
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

6 authors at 3 institutions in 2 countries.

Sharon DixonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK sharon.dixon@phc.ox.ac.uk.ORCID http://orcid.org/0000-0002-7469-6093
Claire DuddyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-7083-6589
Gabrielle HarrisonUniversity Hospitals Coventry and Warwickshire, NHS Trust, Coventry, UK.
Chrysanthi PapoutsiNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Sue ZieblandNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Frances GriffithsCentre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa.ORCID http://orcid.org/0000-0002-4173-1438
University of Oxford · GBUniversity Hospitals Coventry and Warwickshire NHS Trust · GBUniversity of the Witwatersrand · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesLittle is known about the management of female genital mutilation (FGM) in primary care. There have been significant recent statutory changes relevant to general practitioners (GPs) in England, including a mandatory reporting duty. We undertook a realist synthesis to explore what influences how and when GPs discuss FGM with their patients.

settingPrimary care in England. DATA SOURCES: Realist literature synthesis searching 10 databases with terms: GPs, primary care, obstetrics, gynaecology, midwifery and FGM (UK and worldwide). Citation chasing was used, and relevant grey literature was included, including searching FGM advocacy organisation websites for relevant data. Other potentially relevant literature fields were searched for evidence to inform programme theory development. We included all study designs and papers that presented evidence about factors potentially relevant to considering how, why and in what circumstances GPs feel able to discuss FGM with their patients. PRIMARY OUTCOME MEASURE: This realist review developed programme theory, tested against existing evidence, on what influences GPs actions and reactions to FGM in primary care consultations and where, when and why these influences are activated.

results124 documents were included in the synthesis. Our analysis found that GPs need knowledge and training to help them support their patients with FGM, including who may be affected, what needs they may have and how to talk sensitively about FGM. Access to specialist services and guidance may help them with this role. Reporting requirements may complicate these conversations.

conclusionsThere is a pressing need to develop (and evaluate) training to help GPs meet FGM-affected communities' health needs and to promote the accessibility of primary care. Education and resources should be developed in partnership with community members. The impact of the mandatory reporting requirement and the Enhanced Dataset on healthcare interactions in primary care warrants evaluation. PROSPERO REGISTRATION NUMBER: CRD42018091996.

Indexed as

Circumcision, FemaleGeneral PracticeEnglandFemaleHumansPrimary Health CareReferral and Consultationhealth policyorganisation of health servicesprimary carequality in healthcare

Identifiers

PMID33753429
PMCPMC7986780
OpenAlexW3136761213

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.