SynthesisWorld journal of surgery2021
Effectiveness of Quality Improvement Processes, Interventions, and Structure in Trauma Systems in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.
Synthesis in World journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06075108 (P-KIDs CARE), which is not on this map. Cited by 20 papers, 2 of them syntheses that pooled 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.
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.
P-KIDs CARE: An Intervention to Address Health Systems Delays to Care for Injured Children in Tanzania
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effect of trauma life support training on patient outcomes: a systematic review and meta-analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Pooled it
- Quality improvement in public-private partnerships in low- and middle-income countries: a systematic review.BMC health services research · 2024Pooled it
- Feasibility of a cluster randomised trial on the effect of trauma life support training: a pilot study in India.BMJ open · 2025Trial
- Electric bicycle versus conventional bicycle crashes: comparative analysis of injury patterns, severity, and the modifying effect of body mass index.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Article
- Building Capacity in Perioperative Quality Improvement in Low- and Middle- Income Countries: Experiences From Mombasa, Lusaka and Hawassa.World journal of surgery · 2026Article
- Preparedness for treating injured patients at a single-centre trauma hospital in Ethiopia: a qualitative study.Global health action · 2025Article
- Effect of First Aid Training on Motorcyclists and Cyclists' Knowledge, Skills, Attitude, and Self-Efficacy in Managing Road Traffic Accident Victims in Rwanda: A Quasi-Experimental Study.Rwanda journal of medicine and health sciences · 2025Article
- Article
- Pilot implementation projects in low- and middle-income countries to guide surgical quality improvement using best practice recommendations.Frontiers in health services · 2025Article
- BOOTStrap-SCI: Beyond One option of treatment for spinal trauma and spinal cord injury: Consensus-based stratified protocols for pre-hospital care and emergency room (part I).Brain & spine · 2025Article
- Health systems strengthening through surgical and perioperative care pathways: a changing paradigm.BMJ global health · 2024Review
- Preventability of injury-related morbidity & mortality at four hospitals in Cameroon: A systematic approach to trauma quality improvement.World journal of surgery · 2024Article
- Bystander intervention is associated with reduced early mortality among injury victims in Cameroon.PLOS global public health · 2024Article
- Fears and Concerns of Bystanders to Help People Injured in Traffic Accidents: A Qualitative Descriptive Study.Emergency medicine international · 2023Article
- Editorial: Global surgery: the next Frontier in global public health.Frontiers in public health · 2023Article
- Article
- Systems Analysis and Improvement Approach to optimize the pediatric and adolescent HIV Cascade (SAIA-PEDS): a pilot study.Implementation science communications · 2022Article
- Teaching Trauma in Resource-Limited Settings: A Scoping Review of Pediatric Trauma Courses.World journal of surgery · 2022Article
- A survey on the early management of spinal trauma in low and middle-income countries: From the scene of injury to the diagnostic phase (part II).Brain & spine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to decrease trauma mortality.
methodsA systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country trauma systems was conducted from November 1989 to August 2020 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC population according to World Bank Income Classification, occurred in a trauma setting, and measured the effect of implementation and its impact. The primary outcome was trauma mortality.
resultsOf 37,575 search results, 30 studies were included from 15 LMICs covering five WHO regions in a qualitative synthesis. Twenty-seven articles were included in a meta-analysis. Implementing a pre-hospital trauma system reduced overall trauma mortality by 45% (risk ratio (RR) 0.55, 95% CI 0.4 to 0.75). Training first responders resulted in an overall decrease in mortality (RR 0.47, 95% CI 0.28 to 0.78). In-hospital trauma training with certified courses resulted in a reduction of mortality (RR 0.71, 95% CI 0.62 to 0.78). Trauma audits and trauma protocols resulted in varying improvements in trauma mortality.
conclusionThere is evidence that quality improvement processes, interventions, and structure can improve mortality in the trauma systems in LMICs.
Indexed as
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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.