Evidence map›Paper›PMID 37220957›Full record

ArticleCMAJ open

Understanding what patients and physicians need to improve their decision-making about antenatal corticosteroids in late preterm gestation: a qualitative framework analysis.

Hannah Foggin, Rebecca Metcalfe, Jennifer A Hutcheon, Nick Bansback, Jason Burrows, Eda Karacebeyli, Sandesh Shivananda, Amelie Boutin, Jessica Liauw

Abstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Hannah FogginDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC hannah.foggin@gmail.com.
Rebecca MetcalfeDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.
Jennifer A HutcheonDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.
Nick BansbackDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.
Jason BurrowsDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.
Eda KaracebeyliDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.
Sandesh ShivanandaDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.
Amelie BoutinDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.
Jessica LiauwDepartment of Obstetrics and Gynaecology (Foggin, Hutcheon, Burrows, Karacebeyli, Boutin, Liauw); School of Population and Public Health (Metcalfe, Bansback); Department of Pediatrics (Shivananda), University of British Columbia, Vancouver, BC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is unclear whether the benefits of administration of antenatal corticosteroids in late preterm gestation outweigh its harms. We sought to understand whether patients and physicians need increased support to decide whether to administer antenatal corticosteroids in late preterm gestation, and their informational needs and preferences for decision-making roles related to this intervention; we also wanted to know if creation of a decision-support tool would be useful.

methodsWe conducted individual, semistructured interviews with pregnant people, obstetricians and pediatricians in Vancouver, Canada, in 2019. Using a qualitative framework analysis method, we coded, charted and interpreted interview transcripts into categories that formed an analytical framework.

resultsWe included 20 pregnant participants, 10 obstetricians and 10 pediatricians. We organized codes into the following categories: informational needs to decide whether to administer antenatal corticosteroids; preferences for decision-making roles regarding this treatment; the need for support to make this treatment decision; and the preferred format and content of a decision-support tool. Pregnant participants wanted to be involved in decision-making about antenatal corticosteroids in late preterm gestation. They wanted information on the medication, respiratory distress, hypoglycemia, parent-neonate bonding and long-term neurodevelopment. There was variation in physician counselling practices, and in how patients and physicians perceived the balance of treatment harms and benefits. Responses suggested a decision-support tool may be useful. Participants desired clear descriptions of risk magnitude and uncertainty.

interpretationPregnant people and physicians would likely benefit from increased support to consider the harms and benefits of antenatal corticosteroids in late preterm gestation. Creation of a decision-support tool may be useful.

Indexed as

PhysiciansAdrenal Cortex HormonesCanadaDyspneaFemaleHumansInfant, NewbornObstetriciansPregnancyAdrenal Cortex Hormones

Identifiers

PMID37220957
PMCPMC10212573

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Registered trials

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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.