Evidence map›Paper›PMID 39177807›Full record

ReviewResearch in health services & regions2022

Office hours and caesarean section: systematic review and Meta-analysis.

Ilir Hoxha, Arber Lama, Genta Bunjaku, Krenare Grezda, Riaz Agahi, Petrit Beqiri, David C Goodman

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Research in health services & regions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Observational
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

7 authors.

Ilir HoxhaThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03756, USA. ilir.s.hoxha@dartmouth.edu.ORCID http://orcid.org/0000-0003-4262-1406
Arber LamaKolegji Heimerer, 10000, Prishtina, Kosovo.
Genta BunjakuEvidence Synthesis Group, 10000, Prishtina, Kosovo.
Krenare GrezdaEvidence Synthesis Group, 10000, Prishtina, Kosovo.
Riaz AgahiKolegji Heimerer, 10000, Prishtina, Kosovo.
Petrit BeqiriKolegji Heimerer, 10000, Prishtina, Kosovo.
David C GoodmanThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03756, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnnecessary caesarean births may be affected by physician factors, such as preferences, incentives and convenience. Delivery during office hours can be a valuable proxy for measuring such effects.

objectiveTo determine the effect of office hours on the decision for caesarean delivery by assessing the odds of caesarean during office hours compared to out-of-office hours. SEARCH STRATEGY: We searched CINAHL, ClinicalTrials.gov , The Cochrane Library, PubMed, Scopus and Web of Science from the beginning of records through August 2021. DATA COLLECTION AND ANALYSIS: Search results were screened by three researchers. First, we selected studies that reported odds ratios of caesareans, or data allowing their calculation, for office and out-of-office hours. We extracted data on the study population, study design, data sources, setting, type of caesarean section, statistical analysis, and outcome measures. For groups reporting the same outcome, we performed a standard inverse-variance random-effects meta-analysis, which enabled us to calculate the overall odds ratios for each group. For groups reporting varying outcomes, we performed descriptive analysis. MAIN

resultsMeta-analysis of weekday vs weekend for any caesarean section showed higher odds of caesarean during weekdays in adjusted analysis 1.40 (95%CI 1.13, 1.72 from 1,952,691 births). A similar effect was observed in the weekday vs Sunday comparison (1.39, 95%CI 1.10, 1.75, 150,932 births). A lower effect was observed for emergency CS, with a slight increase in adjusted analysis (1.06, 95%CI 0.90, 1.26, 2,622,772 births) and a slightly higher increase in unadjusted analysis (1.15, 95%CI 1.03, 1.29, 12,591,485 births). Similar trends were observed in subgroup analyses and descriptive synthesis of studies examining other office hours outcomes.

conclusionsDelivery during office hours is associated with higher odds for overall caesarean sections and little to no effect for emergency caesarean. Non-clinical factors associated with office hours may influence the decision to deliver by caesarean section. Further detailed investigation of the "office hours effect" in delivery care is necessary and could lead to improvements in care systems.

fundingThe authors received no direct funding for this study.

Indexed as

Caesarean sectionDelivery timeMedical practice variationPhysician conveniencePractice patterns

Identifiers

PMID39177807
PMCPMC11264882

What OpenQuestion holds

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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.