A systematic review and meta‐synthesis of qualitative studies on pelvic organ prolapse for the development of core outcome sets

Rada, Maria Patricia; Jones, Stephanie P.; Falconi, Gabriele; Haddad, Jorge Milhem; Betschart, Cornelia; Pergialiotis, Vasilios; Doumouchtsis, Stergios K.

doi:10.1002/nau.24297

Cited by 27 publications

(23 citation statements)

References 38 publications

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“…We followed a standardised methodological approach in line with previous experience and expertise developed within CHORUS as well as recommended COMET guidelines in relation to systematic reviews and the development of COS 10–16 …”

Section: Methodsmentioning

confidence: 99%

A systematic review on reported outcomes and outcome measures in female idiopathic chronic pelvic pain for the development of a core outcome set

Ghai

Subramanian

Jan

et al. 2020

BJOG

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Background A core outcome set (COS) is required to address inconsistencies in outcome reporting in chronic pelvic pain (CPP) trials. Objectives Evaluation of reported outcomes and selected outcome measures in CPP trials by producing a comprehensive inventory to inform a COS. Search strategy Systematic review of randomised controlled trials (RCTs) identified from Cochrane Central Register of Controlled Trials (CENTRAL), Embase and MEDLINE databases. Selection criteria RCTs assessing efficacy and safety of medical, surgical and psychological interventions for women with idiopathic CPP. Data collection and analysis Two independent researchers extracted outcomes and outcome measures. Similar outcomes were grouped and classified into domains to produce a structured inventory. Main results Twenty‐four trials were identified including 136 reported outcomes and outcome measures. Rates of reporting outcomes varied (4–100%) and pelvic pain was the most frequently reported outcome (100%). All trials reported the pain domain; however, only half reported quality of life, clinical effectiveness and adverse events. No differences in outcome reporting were observed in five high‐quality trials (21%). Univariate analysis demonstrated an association between quality of outcome reporting and methodological quality of studies (rs = 0.407, P = 0.048). Conclusion There is wide variation in reported outcomes and applied outcome measures in CPP trials. While a COS is being developed and implemented, we propose the interim use of commonly reported outcomes in each domain: pain (pelvic pain, dyspareunia, dysmenorrhoea), life impact (quality of life, emotional functioning, physical functioning), clinical effectiveness (efficacy, satisfaction, cost effectiveness, return to daily activities) and adverse events (surgical, perioperative observations, nonsurgical). Tweetable abstract There is significant variation in outcome reporting in CPP trials. Our systematic review forms the basis for the development of a core outcome set.

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Section: Methodsmentioning

confidence: 99%

A systematic review on reported outcomes and outcome measures in female idiopathic chronic pelvic pain for the development of a core outcome set

Ghai

Subramanian

Jan

et al. 2020

BJOG

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“…To determine the need for a QES to explore the experience of living with POP, we first searched for any existing QES, using search terms designed for that purpose [5]. We found one QES which aimed to identify core treatment outcomes for POP [6]. Our innovation was to undertake a comprehensive search and conceptual synthesis of primary qualitative research using the methods of meta-ethnography to help us to understand what it like to live with POP.…”

Section: Stage 1: Selecting Meta-ethnography and Getting Startedmentioning

confidence: 99%

A qualitative evidence synthesis using meta-ethnography to understand the experience of living with pelvic organ prolapse

et al. 2020

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Introduction and hypothesis Pelvic organ prolapse (POP) affects the lives of many people. We aimed to systematically search for, identify and synthesize qualitative research that explores what it is like to live with POP and make this knowledge available for healthcare improvement. Methods We systematically searched Medline, PsychInfo, Embase and CINAHL, from inception to March 2020, for qualitative research exploring the experience of living with POP. We used meta-ethnography to synthesize findings. This is a conceptual approach to qualitative evidence synthesis. We used the recent guidelines for reporting meta-ethnography. Results We screened 3103 titles and 255 abstracts and included 37 primary studies. These incorporated the experience of 777 women, (aged 18 to 95 years) from a range of countries. We organized 162 ideas into 27 conceptual categories and 10 themes. We developed a conceptual model that helps us to understand the experience of pelvic organ prolapse. This model indicates that (1) the physical losses of POP are intricately linked to loss of identity; (2) women conceptualized POP as part of womanhood, yet also its thief; (3) there is a vicious cycle of taboo, silence and misunderstanding about POP and its treatment; (4) this silence is exacerbated by a feeling that POP is not taken seriously in healthcare. Conclusions This meta-ethnography helps us to understand the experience of living with a POP. Our model illustrates the complex process of healthcare decision making. Further studies to explore the complexity of decision making from the perspective of patient and health professional are timely.

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“…We used robust and reproducible methods including independent analysis from two researchers to minimize bias arising from data selection, collection and analysis. This methodology has been successfully applied in previous studies and is an established study design [ 14 ]. Furthermore, to improve the scientific rigour of this review, a quality assessment of included studies was performed using the CASP tool.…”

Section: Discussionmentioning

confidence: 99%

“…This study has been performed by a working group of CHORUS, an International Collaboration for Harmonizing Outcomes, Research and Standards in Urogynaecology and Women's Health (https://i-chorus.org), aiming to address outcome reporting, research quality and research and clinical standards in the areas of urogynaecology, female pelvic medicine and reconstructive surgery [14][15][16]. This project is part of a wider initiative to develop core outcome sets (COS) in therapeutic interventions for female CPP that has been prospectively registered with the Core Outcome Measures in Effectiveness Trials (COMET initiative), number 981.…”

Section: Methodsmentioning

confidence: 99%

A meta-synthesis of qualitative literature on female chronic pelvic pain for the development of a core outcome set: a systematic review

et al. 2021

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Introduction and hypothesis Qualitative research has an increasing role in the development of core outcome sets (COS) adding patient perspectives to the considerations of core outcomes. We aimed to identify priorities of women with experience of chronic pelvic pain (CPP). Methods The search strategy was a systematic review of qualitative studies identified from Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, EMBASE, MEDLINE and PsycInfo databases. Selection criteria were qualitative studies exploring the experience of women with CPP. Two independent researchers extracted data and summarized findings using thematic analysis. A CERQual assessment was performed to assess the confidence of review findings. Results We identified pertinent issues affecting women with CPP including the lack of holistic care, influence of psychosocial factors and the impact of pain on quality of life. Five meta-themes central to delivering a patient-centred approach were highlighted: acceptance of pain, quality of life, management of CPP, communication and support. Management of CPP was the most commonly reported meta-theme across seven studies and half of studies reported quality of life, management, communication and support. Quality appraisal of included studies identified only a single study that met all CASP (Critical Appraisal Skills Programme) criteria. There was high confidence in the evidence for acceptance of pain, quality of life and communication meta-themes. Conclusion Meta-themes revealed by this review should be considered as a priority and reflected in outcomes reported by future studies evaluating interventions for CPP. In addition, these themes should be considered by clinicians managing women with CPP.

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A systematic review and meta‐synthesis of qualitative studies on pelvic organ prolapse for the development of core outcome sets

Cited by 27 publications

References 38 publications

A systematic review on reported outcomes and outcome measures in female idiopathic chronic pelvic pain for the development of a core outcome set

A systematic review on reported outcomes and outcome measures in female idiopathic chronic pelvic pain for the development of a core outcome set

A qualitative evidence synthesis using meta-ethnography to understand the experience of living with pelvic organ prolapse

A meta-synthesis of qualitative literature on female chronic pelvic pain for the development of a core outcome set: a systematic review

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