Evidence map›Paper›PMID 34352810›Full record

GuidelineObstetrics and gynecology2021

The Michigan Plan for Appropriate Tailored Healthcare in Pregnancy Prenatal Care Recommendations.

Alex Friedman Peahl, Christopher M Zahn, Mark Turrentine, Wanda Barfield, Sean D Blackwell, Suni Jo Roberts, Allison R Powell, Vineet Chopra, Steven J Bernstein

Abstract readPractice Guideline
In one paragraph

Guideline in Obstetrics and gynecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
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

20 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Cannabis and Nicotine Substance Use Coercion During the Perinatal Period.Women's health reports (New Rochelle, N.Y.) · 2025
    Article
  6. Adherence to recommended prenatal visit schedules and risk for stillbirth, according to probable cause of death.European journal of obstetrics, gynecology, and reproductive biology · 2024
    Article
  7. Article
  8. Article
  9. Maternal Vaccination and Vaccine Hesitancy.Pediatric clinics of North America · 2023
    Review
  10. AJOG global reports · 2023
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. 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

9 authors.

Alex Friedman PeahlDepartment of Obstetrics and Gynecology, the Institute for Healthcare Policy and Innovation, the Program on Women's Healthcare Effectiveness Research, the Department of Internal Medicine, and the Department of Hospital Medicine, University of Michigan, Ann Arbor, Michigan; the American College of Obstetricians and Gynecologists, Washington, DC; the Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas; the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and the Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School-UTHealth, Houston, Texas; and the University of Michigan Medical School and the Safety Enhancement Program and Center for Clinical Management Research, U.S. Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
Christopher M Zahn
Mark Turrentine
Wanda Barfield
Sean D Blackwell
Suni Jo Roberts
Allison R Powell
Vineet Chopra
Steven J Bernstein

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

objectiveTo describe MiPATH (the Michigan Plan for Appropriate Tailored Healthcare in pregnancy) panel process and key recommendations for prenatal care delivery.

methodsWe conducted an appropriateness study using the RAND Corporation and University of California Los Angeles Appropriateness Method, a modified e-Delphi process, to develop MiPATH recommendations using sequential steps: 1) definition and scope of key terms, 2) literature review and data synthesis, 3) case scenario development, 4) panel selection and scenario revisions, and 5) two rounds of panel appropriateness ratings with deliberation. Recommendations were developed for average-risk pregnant individuals (eg, individuals not requiring care by maternal-fetal medicine specialists). Because prenatal services (eg, laboratory tests, vaccinations) have robust evidence, panelists considered only how services are delivered (eg, visit frequency, telemedicine).

resultsThe appropriateness of key aspects of prenatal care delivery across individuals with and without common medical and pregnancy complications, as well as social and structural determinants of health, was determined by the panel. Panelists agreed that a risk assessment for medical, social, and structural determinants of health should be completed as soon as individuals present for care. Additionally, the panel provided recommendations for: 1) prenatal visit schedules (care initiation, visit timing and frequency, routine pregnancy assessments), 2) integration of telemedicine (virtual visits and home devices), and 3) care individualization. Panelists recognized significant gaps in existing evidence and the need for policy changes to support equitable care with changing practices.

conclusionThe MiPATH recommendations offer more flexible prenatal care delivery for average-risk individuals.

Indexed as

Delivery of Health CareDelphi TechniqueFemaleHumansInfant, NewbornMichiganPregnancyPregnancy ComplicationsPrenatal CareRisk AssessmentRisk FactorsSocial Determinants of HealthTelemedicineUltrasonography, Prenatal

Identifiers

PMID34352810
PMCPMC12101528

What OpenQuestion holds

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LicenceTDM
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.