Evidence map›Paper›PMID 34556061›Full record

ArticleBMC pregnancy and childbirth2021

Patient decision aid for trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery: a quasi-experimental pre-post study.

Kartik K Venkatesh, Suzanne Brodney, Michael J Barry, Jamie Jackson, Kiira M Lyons, Asha N Talati, Thomas S Ivester, Maria C Munoz, John M Thorp, Wanda K Nicholson

Registry-linked trialAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04053413 (Pilot Study to Assess the Effectiveness of a Decision Tool for Cesarean Delivery vs. Trial of Labor), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

NCT04053413 nacompletednot on this map

Pilot Study to Assess the Effectiveness of a Decision Tool for Cesarean Delivery vs. Trial of Labor

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2018 to 2019Enrolled100ConditionsScar, Previous Cesarean Section, Vaginal Birth After Cesarean, Decision Making, SharedArmsDecision Aid
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 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

10 authors.

Kartik K VenkateshDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, 395 W. 12th Ave., Floor 5, Columbus, OH, USA. kartik.venkatesh@osumc.edu.
Suzanne BrodneyInformed Medical Decisions Program, Massachusetts General Hospital, Boston, MA, USA.
Michael J BarryInformed Medical Decisions Program, Massachusetts General Hospital, Boston, MA, USA.
Jamie JacksonDivision of General Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Kiira M LyonsDivision of General Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Asha N TalatiDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Thomas S IvesterDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Maria C MunozDivision of General Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
John M ThorpDivision of General Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Wanda K NicholsonDivision of General Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the impact of a web-based decision aid on patient-centered decision making outcomes among women considering a trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery.

methodsThe Birth Decision Aid Study (B-READY) was a quasi-experimental pre-post study of two sequential cohorts. From June 18, 2018 to July 31, 2019, 50 women were enrolled in routine care, followed by 50 women who were enrolled in the decision aid group. Inclusion criteria were singleton pregnancies between 19/0 to 36/6 weeks, ≤2 prior cesareans, and no contraindications to TOLAC. The decision aid group viewed the online Healthwise® "Pregnancy: Birth Options After Cesarean" program. Both groups received the same birth options counseling and completed the same online assessment. Primary patient-centered outcomes were knowledge about birth options and shared decision making at online assessment, and informed, patient-centered decision making about her preferred mode of delivery at delivery admission.

resultsAmong 100 women participated in this study (50 per group), the mean gestational age at enrollment was 31 weeks, and 71% or 63/89 women who consented to delivery data abstraction had a cesarean delivery. Women in the patient decision aid group gained more knowledge (defined as score ≥ 75%) about birth options compared to those in the routine care group (72% vs. 32%; adjusted odds ratio, AOR: 6.15 [95% CI: 2.34 to 16.14]), and were more likely to make an informed, patient-centered decision (60% vs. 26%; AOR: 3.30 [95% CI: 1.20 to 9.04]. Women in both groups reported similar involvement in shared decision making, as well as satisfaction and values. More than 90% of decision aid users reported it was a useful tool and would recommend it to other TOLAC-eligible women.

conclusionsA web-based birth options patient-centered decision aid for TOLAC eligible women can be integrated into prenatal Telehealth and may improve the quality of decision making about mode of delivery.

trial registrationThe study was registered with ClinincalTrials.gov and the ID# was NCT04053413 . Registered 12 August 2019 - Retrospectively registered.

Indexed as

Decision MakingDecision Support TechniquesHealth Knowledge, Attitudes, PracticeTrial of LaborAdultCesarean Section, RepeatCohort StudiesFemaleHumansInternetPatient-Centered CarePregnancyVaginal Birth after CesareanYoung AdultCesarean deliveryDecision aidShared decision makingTelehealthTrial of labor after cesareanVaginal birth after cesarean

Identifiers

PMID34556061
PMCPMC8461956

What OpenQuestion holds

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LicenceCC BY
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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.