Table 3 CERQual Evidence Profile—Example A
Summary of review finding | Studies contributing to the review finding | Methodological limitations | Coherence | Adequacy | Relevancea | CERQual assessment of confidence in the evidence | Explanation of CERQual assessment |
|---|---|---|---|---|---|---|---|
1. Use of force: Women across the world reported experiencing physical force by health providers during childbirth. In some cases, women reported specific acts of violence committed against them during childbirth, but women often referred to these experiences in a general sense and alluded to beatings, aggression, physical abuse, a rough touch and use of extreme force. Pinching, hitting and slapping, either with an open hand or an instrument were the most commonly reported specific acts of physical violence. | 6, 9, 10, 13, 21, 61, 67, 68, 73, 75, 77, 80, 84, 86, 87, 91, 96, 97 | Moderate methodological limitations (6 studies with minor, 6 studies with moderate (unclear recruitment and sampling), and 3 studies with serious methodological limitations (unclear reflexivity, insufficiently rigorous data analysis)) | No or very minor concerns about coherence | No or very minor concerns about adequacy | Minor concerns about relevance (5 studies with direct relevance, 8 studies with partial relevance, and 1 study with unclear relevance. 15 studies total from 10 countries, including 1 high income, 2 middle income and 7 low income countries. Geographical spread: 2 studies in Asia, 1 study in Europe, 1 study in LAC, 1 study in MENA, 1 study in South America, and 8 studies from sub-Saharan Africa.) | High confidence | 15 studies with moderate methodological limitations. Data from 10 countries across all geographical regions, but predominantly sub-Saharan Africa. No or very minor concerns about coherence and adequacy. |
2. Physical restraint: Women in Tanzania and Brazil reported physical restraint during childbirth through the use of bed restraints and mouth gags. | 86, 97 | Moderate methodological limitations (1 study with minor and 1 study with serious methodological limitations (inappropriate research design, no reflexivity, unclear ethical considerations)) | Minor concerns about coherence (Some concerns about the fit between the data from primary studies and the review finding) | Serious concerns about adequacy (2 studies in total with limited, thin data) | Moderate concerns about relevance (2 studies with partial relevance from 2 countries) | Very low confidence | Two studies (Tanzania and Brazil) with moderate methodological limitations. Limited, thin data from 2 countries. Minor concerns about coherence but limited data available. |