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A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study
OBJECTIVE: To generate a global reference for caesarean section (CS) rates at health facilities. DESIGN: Cross‐sectional study. SETTING: Health facilities from 43 countries. POPULATION/SAMPLE: Thirty eight thousand three hundred and twenty‐four women giving birth from 22 countries for model building...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873961/ https://www.ncbi.nlm.nih.gov/pubmed/26259689 http://dx.doi.org/10.1111/1471-0528.13509 |
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author | Souza, JP Betran, AP Dumont, A de Mucio, B Gibbs Pickens, CM Deneux‐Tharaux, C Ortiz‐Panozo, E Sullivan, E Ota, E Togoobaatar, G Carroli, G Knight, H Zhang, J Cecatti, JG Vogel, JP Jayaratne, K Leal, MC Gissler, M Morisaki, N Lack, N Oladapo, OT Tunçalp, Ö Lumbiganon, P Mori, R Quintana, S Costa Passos, AD Marcolin, AC Zongo, A Blondel, B Hernández, B Hogue, CJ Prunet, C Landman, C Ochir, C Cuesta, C Pileggi‐Castro, C Walker, D Alves, D Abalos, E Moises, ECD Vieira, EM Duarte, G Perdona, G Gurol‐Urganci, I Takahiko, K Moscovici, L Campodonico, L Oliveira‐Ciabati, L Laopaiboon, M Danansuriya, M Nakamura‐Pereira, M Costa, ML Torloni, MR Kramer, MR Borges, P Olkhanud, PB Pérez‐Cuevas, R Agampodi, SB Mittal, S Serruya, S Bataglia, V Li, Z Temmerman, M Gülmezoglu, AM |
author_facet | Souza, JP Betran, AP Dumont, A de Mucio, B Gibbs Pickens, CM Deneux‐Tharaux, C Ortiz‐Panozo, E Sullivan, E Ota, E Togoobaatar, G Carroli, G Knight, H Zhang, J Cecatti, JG Vogel, JP Jayaratne, K Leal, MC Gissler, M Morisaki, N Lack, N Oladapo, OT Tunçalp, Ö Lumbiganon, P Mori, R Quintana, S Costa Passos, AD Marcolin, AC Zongo, A Blondel, B Hernández, B Hogue, CJ Prunet, C Landman, C Ochir, C Cuesta, C Pileggi‐Castro, C Walker, D Alves, D Abalos, E Moises, ECD Vieira, EM Duarte, G Perdona, G Gurol‐Urganci, I Takahiko, K Moscovici, L Campodonico, L Oliveira‐Ciabati, L Laopaiboon, M Danansuriya, M Nakamura‐Pereira, M Costa, ML Torloni, MR Kramer, MR Borges, P Olkhanud, PB Pérez‐Cuevas, R Agampodi, SB Mittal, S Serruya, S Bataglia, V Li, Z Temmerman, M Gülmezoglu, AM |
author_sort | Souza, JP |
collection | PubMed |
description | OBJECTIVE: To generate a global reference for caesarean section (CS) rates at health facilities. DESIGN: Cross‐sectional study. SETTING: Health facilities from 43 countries. POPULATION/SAMPLE: Thirty eight thousand three hundred and twenty‐four women giving birth from 22 countries for model building and 10 045 875 women giving birth from 43 countries for model testing. METHODS: We hypothesised that mathematical models could determine the relationship between clinical‐obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three‐step approach to generate the global benchmark of CS rates at health facilities: creation of a multi‐country reference population, building mathematical models, and testing these models. MAIN OUTCOME MEASURES: Area under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate. RESULTS: According to the different versions of the model, areas under the ROC curves suggested a good discriminatory capacity of C‐Model, with summary estimates ranging from 0.832 to 0.844. The C‐Model was able to generate expected CS rates adjusted for the case‐mix of the obstetric population. We have also prepared an e‐calculator to facilitate use of C‐Model (www.who.int/reproductivehealth/publications/maternal_perinatal_health/c-model/en/). CONCLUSIONS: This article describes the development of a global reference for CS rates. Based on maternal characteristics, this tool was able to generate an individualised expected CS rate for health facilities or groups of health facilities. With C‐Model, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference CS rate for assessing use (and overuse) of CS. TWEETABLE ABSTRACT: The C‐Model provides a customized benchmark for caesarean section rates in health facilities and systems. |
format | Online Article Text |
id | pubmed-4873961 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-48739612016-05-20 A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study Souza, JP Betran, AP Dumont, A de Mucio, B Gibbs Pickens, CM Deneux‐Tharaux, C Ortiz‐Panozo, E Sullivan, E Ota, E Togoobaatar, G Carroli, G Knight, H Zhang, J Cecatti, JG Vogel, JP Jayaratne, K Leal, MC Gissler, M Morisaki, N Lack, N Oladapo, OT Tunçalp, Ö Lumbiganon, P Mori, R Quintana, S Costa Passos, AD Marcolin, AC Zongo, A Blondel, B Hernández, B Hogue, CJ Prunet, C Landman, C Ochir, C Cuesta, C Pileggi‐Castro, C Walker, D Alves, D Abalos, E Moises, ECD Vieira, EM Duarte, G Perdona, G Gurol‐Urganci, I Takahiko, K Moscovici, L Campodonico, L Oliveira‐Ciabati, L Laopaiboon, M Danansuriya, M Nakamura‐Pereira, M Costa, ML Torloni, MR Kramer, MR Borges, P Olkhanud, PB Pérez‐Cuevas, R Agampodi, SB Mittal, S Serruya, S Bataglia, V Li, Z Temmerman, M Gülmezoglu, AM BJOG General Obstetrics OBJECTIVE: To generate a global reference for caesarean section (CS) rates at health facilities. DESIGN: Cross‐sectional study. SETTING: Health facilities from 43 countries. POPULATION/SAMPLE: Thirty eight thousand three hundred and twenty‐four women giving birth from 22 countries for model building and 10 045 875 women giving birth from 43 countries for model testing. METHODS: We hypothesised that mathematical models could determine the relationship between clinical‐obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three‐step approach to generate the global benchmark of CS rates at health facilities: creation of a multi‐country reference population, building mathematical models, and testing these models. MAIN OUTCOME MEASURES: Area under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate. RESULTS: According to the different versions of the model, areas under the ROC curves suggested a good discriminatory capacity of C‐Model, with summary estimates ranging from 0.832 to 0.844. The C‐Model was able to generate expected CS rates adjusted for the case‐mix of the obstetric population. We have also prepared an e‐calculator to facilitate use of C‐Model (www.who.int/reproductivehealth/publications/maternal_perinatal_health/c-model/en/). CONCLUSIONS: This article describes the development of a global reference for CS rates. Based on maternal characteristics, this tool was able to generate an individualised expected CS rate for health facilities or groups of health facilities. With C‐Model, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference CS rate for assessing use (and overuse) of CS. TWEETABLE ABSTRACT: The C‐Model provides a customized benchmark for caesarean section rates in health facilities and systems. John Wiley and Sons Inc. 2016-02 2015-08-10 /pmc/articles/PMC4873961/ /pubmed/26259689 http://dx.doi.org/10.1111/1471-0528.13509 Text en © 2015 World Health Organization; licensed by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (https://creativecommons.org/licenses/by/3.0/igo/legalcode) which permits unrestricted use, distribution and reproduction in any medium, provided that the original work is properly cited. |
spellingShingle | General Obstetrics Souza, JP Betran, AP Dumont, A de Mucio, B Gibbs Pickens, CM Deneux‐Tharaux, C Ortiz‐Panozo, E Sullivan, E Ota, E Togoobaatar, G Carroli, G Knight, H Zhang, J Cecatti, JG Vogel, JP Jayaratne, K Leal, MC Gissler, M Morisaki, N Lack, N Oladapo, OT Tunçalp, Ö Lumbiganon, P Mori, R Quintana, S Costa Passos, AD Marcolin, AC Zongo, A Blondel, B Hernández, B Hogue, CJ Prunet, C Landman, C Ochir, C Cuesta, C Pileggi‐Castro, C Walker, D Alves, D Abalos, E Moises, ECD Vieira, EM Duarte, G Perdona, G Gurol‐Urganci, I Takahiko, K Moscovici, L Campodonico, L Oliveira‐Ciabati, L Laopaiboon, M Danansuriya, M Nakamura‐Pereira, M Costa, ML Torloni, MR Kramer, MR Borges, P Olkhanud, PB Pérez‐Cuevas, R Agampodi, SB Mittal, S Serruya, S Bataglia, V Li, Z Temmerman, M Gülmezoglu, AM A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study |
title | A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study |
title_full | A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study |
title_fullStr | A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study |
title_full_unstemmed | A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study |
title_short | A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study |
title_sort | global reference for caesarean section rates (c‐model): a multicountry cross‐sectional study |
topic | General Obstetrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873961/ https://www.ncbi.nlm.nih.gov/pubmed/26259689 http://dx.doi.org/10.1111/1471-0528.13509 |
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