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Guise JM, Eden K, Emeis C, et al. Vaginal Birth After Cesarean: New Insights. Rockville (MD): Agency for Healthcare Research and Quality (US); 2010 Mar. (Evidence Reports/Technology Assessments, No. 191.)

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Vaginal Birth After Cesarean: New Insights.

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Appendix IIndividual Quality Rating Tables

Quality Ratings of Randomized Controlled Trials

Study, YearRandom assignmentAllocation concealedGroups comparable at baseline & maintainedEligibility criteria specifiedBlinded: Outcome Assessors/Care Provider/PatientReport of attrition Differential loss to follow-upAnalysis considerationsQuality Score
Grubb, 19961YesNoYesYesNo/No/No8/188 lost to follow-up, <20%YesFair
Peleg, 19992YesYesNRYesNo/No/NoUnclearUnclearFair
Thubisi, 19933No. “Allocated alternately by admitting clerks”NoYesYesNo/No/NoNo data givenNoPoor*
Wing, 19984NRNRNR/NRYesNo/No/NoNo data givenNoPoor*

Quality Ratings of Cohort Studies

Study, YearAssembly of GroupsMaintenance of comparable groupsOutcome measures reliable & validOutcome assessor blind to exposure statusMissing dataFollow-up long enough for outcomes to occurConsider/adjust for potential confounders (obstetric conditions)Quality Score
Amir, 19875YesYesUnclearUnclearNoneYesYes/NoFair
Asakura, 19956UnclearUnclearUnclearNoUnclearYesNo/NoPoor*
Bahtiyar, 20067YesYesNoNoUnclearYesYes/YesFair
Bais, 20018YesUnclearYesYesNoYesYes/NoFair
Bashiri, 20089YesNoYesYesNoYesYes/YesGood
Blanchette, 199910YesUnclearUnclearNot reportedNot reportedYesNo/NoPoor*
Blanchette, 200111UnclearNoNoUnclearUnclearYesYes/Yes for uterine rupture, no for all othersPoor*
Bujold, 200212YesNoUnclearUnclearUnclearYesYes/YesFair
Bujold, 200213YesYesYesNoNoYesYes/YesGood
Bujold, 200414YesYesUnclearNoNoYesYes/YesFair
Bujold, 200415YesYesUnclearNoNoYesYes/YesFair
Bujold, 200516YesYesYesNot reportedNoYesYes/YesGood
Cahill, 200617YesNoYesYesNoYesYes/YesFair
Carroll, 200318YesUnclearUnclearUnclearUnclearYesYes/YesFair
Caughey, 199919YesYesUnclearUnclear<20%YesYes/YesFair
Chang, 200820YesYesYesNoNoneYesYes/YesGood
Chapman, 199721YesNoUnclearUnclearUnclearYesNo/NoPoor*
Chauhan, 200122YesNoYesUnclearNoYesYes/SomeFair
Chauhan, 200223YesUnclearUnclearNoLow, 1/156YesYes/YesFair
Chestnut, 198524UnclearYesUnclearNoMaternal morbidity for post-op: 25%; Other outcomes: 0% for other outcomesYesSome/NoPoor*
Coughlan, 200225YesNoYesUnclearUnclearYesNo/NoPoor*
DeFranco, 200726YesYesYesNoNoneYesYes/YesGood
Delaney, 200327YesYesYesUnclearNoneYesYes/NoFair
Dhall, 198728YesUnclearUnclearUnclearNot reportedYesYes/YesPoor*
DiMaio, 200229YesNoYesUnclearNot applicableYesNoFair
Dinsmoor, 200430YesNoYesYesLow, 12%YesYes/YesFair
Duff, 198831YesUnclearYesUnclearUnclearYesNo/NoPoor*
Durnwald, 200432UnclearUnclearYesUnclearUnclearYesYes/YesFair
Durnwald, 200433YesYesNoNoNoYesNo/NoFair
Edwards, 200334YesUnclearNoNoNoYesYes/NoPoor*
Eglinton, 198435YesUnclearYesUnclearLow, 5%YesYes/YesFair
Elkousy, 200336UnclearUnclearNoUnclearUnclearYesYes/YesFair
El-Sayed, 200737UnclearNot applicableUnclearNo<20%YesYes/YesFair
Eriksen, 198938UnclearYesUnclearUnclearNoYesSome/NoFair
Fisler, 200339YesYesYesNoNoYesYes/YesFair
Flamm, 198740YesNot applicableYesNoNot applicableYesYes/YesFair
Flamm, 198941YesUnclearUnclearNoNoUnclearNo/NoPoor*
Flamm, 199442YesNot applicableYesNoNot applicableYesYes/YesGood
Flamm, 199743YesYesYesNoNot applicableYesYes/YesGood
Gemer, 199244YesUnclearYesUnclearNoYesYes/NoPoor*
Getahun, 200645UnclearUnclearUnclearUnclearUnclearYesYes/YesPoor*
Gibson, 198846UnclearUnclearUnclearNoNoneYesNo/NoFair
Gonen, 200647UnclearNoYesNoUnclearYesYes/YesFair
Gonen, 200748YesNoUnclearUnclearUnclearYesNo/NoPoor*
Goodall, 200549YesUnclearYesUnclearNoYesYes/YesFair
Granovsky- Grisaru, 199450YesUnclearUnclearUnclearNot applicableYesYes/YesFair
Gregory, 199951YesNot applicableYesNot applicableNot applicableNot applicableYes/YesGood
Gregory, 200852YesNoNoNoUnclearUnclearYes/YesFair
Grobman, 200753YesUnclearYesYesNoYesYes/YesGood
Grobman, 200854YesUnclearYesNoMissing 30% of body mass indexes, and 25% of prior birth weightsYesYes/YesGood
Grossetti, 200755UnclearYesUnclearNoNoYesUnclearFair
Hammoud, 200456YesNoUnclearUnclearUnclearYesYes/YesFair
Hansell, 199057YesYesYesYesNoYesYes/NoFair
Hashima, 200758YesNoYesYesUnclearYesYes/YesFair
Hemminki, 200559YesUnclearUnclearUnclear1.20%YesYes/YesFair
Hershkowitz, 199560YesUnclearUnclearUnclearUnclearYesYes/YesFair
Hibbard, 200161UnclearNoYesUnclearERCD: 2.4%; VBAC: 6.9%YesYes/YesFair
Hibbard, 200662YesYesYesNoNoYesYes/YesGood
Hollard, 200663YesNoYesYesNoYesYes/YesGood
Hook, 199764YesYesYesNot reportedNoYesYes/YesGood
Horenstein, 198465UnclearYesUnclearNoNoYesVery little/NoFair
Horenstein, 198566UnclearYesUnclearNoNoYesVery little/NoFair
Hoskins, 199767YesNot applicableYesUnclearNot applicableYesNoFair
Johnson, 199168YesUnclearYesNoUnclearYesNo/NoFair
Juhasz, 200569YesUnclearYesUnclearNoYesYes/YesFair
Kamath, 200970YesNoYesNoNoYesYes/YesFair
Kayani, 200571YesYesUnclearNoNoYesVery little/NoFair
Kugler, 200872UnclearNot applicableNoNoNoYesNo/NoFair
Kwee, 200773YesUnclearYesNoNoYesNo/NoFair
Landon, 200474YesNoYesNo< 20%YesYes/YesFair
Landon, 200675YesNoYesUnclear<20% - 7% (unknown intent to trial of labor)YesYes/YesFair
Lieberman, 200476YesYesUnclearNoUnclearYesYes/NoFair
Lin, 200477YesYesYesNoNoYesUnclearFair
Loebel, 200478UnclearYesUnclearNoNoYesNo/NoFair
Lydon-Rochelle, 200179YesNoUnclearUnclearNo data givenYesYes/YesFair
Lyndon-Rochelle, 200180YesNot applicableNoNoNot applicableYesYes/YesPoor*
Macones, 200581YesNot applicableYesNoNot applicableYesYes/NoFair
Martin, 198382YesNot applicableYes. No for feverNoNot applicableYesNo/NoFair
McMahon, 199683YesNot applicableYesNoNot applicableYesYes/YesGood
Melnikow, 200184YesUnclearYesYesLow, 73/1662Not applicableNot reportedFair
Miller, 199285YesNot applicableYesYesNot applicableNot applicableNo/NoPoor*
Naef, 199586YesNoYesNoUnclearYesNo/NoPoor*
Nisenblat, 200687YesNoYesNoUnclearYesYes/YesFair
Obara, 199888YesNoUnclearUnclearUnclearYesYes/NoFair
Odibo, 200789YesUnclearunclearUnclearUnclearYesYes/YesFair
Ogunyemi, 199890YesNoUnclearNot applicableNoYesNo/NoPoor*
Ouzounian, 199691UnclearYesYesNoNoYesNo/NoFair
Paterson, 199192YesYesUnclearUnclearNot applicableYesUnclearFair
Pathadey, 200593YesYesUnclearNoNoYesYes/NoFair
Paul, 198594YesNot applicableYesNoNot applicableYesYes/NoFair
Peaceman, 200695YesNoYesUnclearUnclearYesYes/YesFair
Phelan, 198796YesNot applicableYesNoNot applicableYesYes/NoFair
Phelan, 198997YesUnclearYes for uterine rupture. No for feverYesNoYesYes/NoPoor*
Pruett, 198898YesUnclearYesNoUnclearYesNo/NoPoor*
Quinones, 200599UnclearUnclearYesNolowYesYes/YesFair
Rageth, 1999100NoNot applicableNoNoNot applicableYesNo/NoPoor*
Ravasia, 2000101UnclearNoNoNoNoYesNo/NoPoor*
Raynor, 1993102YesNot applicableYesUnclearNot applicableYesNoFair
Richardson, 2005103YesUnclearYesNoNoYesYes/YesFair
Richter, 2002104YesNoYesNoNoYesSome/NoFair
Rozenberg, 1996105YesYesYesYesNoYesYes/YesGood
Rozenberg, 1999106NoYesYesNoNoYesYes/UnclearFair
Rudick, 1984107YesYesUnclearNoNoYesYes/NoFair
Russillo, 2008108YesUnclearUnclearYesNoYesYes/NoPoor*
Sakala, 1990109YesYesUnclearNoNoYesYes/NoFair
Sakala, 1990110UnclearUnclearUnclearNoNoYesNo/NoPoor*
Schneider, 1988111Inclusion criteria are described, but methods to ascertain group are not discussed. Elective repeat cesarean group includes medical and obstetric reasons as well as maternal decisions, and methods for ascertaining the reason are not describedUnclearUnclearUnclearNoYesYes/NoPoor*
Sciscione, 2008112YesNoYesYesNoYesYes/YesGood
Shipp, 2008113YesNoYesYesNoYesYes/YesFair
Smith, 2002114YesYesYesNoNoYesYes/SomeGood
Socol, 1999115YesUnclearYesUnclearNoYesNo/NoFair
Spaans, 2003116YesUnclearUnclearUnclearUnclearYesNo/NoPoor*
Spong, 2007117Yes. However, the number (39,177) for term singleton gestation with prior cesarean is different from prior publication (Landon, 2006)YesYesNoYesYesYes/YesFair
Stone, 2000118UnclearNot applicableUnclearNoNot applicableYesNo/NoPoor*
Strong, 1992119UnclearYesNoNoNoYesNo/NoPoor*
Stovall, 1987120YesNot applicableYes/YesUnclearNot applicableYesNoFair
Tahilramaney, 1984121YesYesUnclearNoNoYesYes/YesFair
Tucker, 1993122YesUnclearNoNoNoYesNo/NoPoor*
Upadhyaya, 2003123UnclearUnclearYesUnclearNot applicableYesYes/YesFair
Van der Walt, 1994124UnclearUnclearYesUnclearYesYesYes/YesFair
Van Gelderen, 1986125UnclearYesUnclearNoNoYesNo/NoFair
Videla, 1995126YesUnclearNoNoYesYesNo/NoPoor*
Weinstein, 1996127YesYesFor some, not for othersNoNot applicableYesYes/YesFair
Wen, 2004128UnclearYesUnclearNoNoYesSome/SomeFair
Yetman, 1989129YesUnclearNoYesLow, 5%YesNo/NoFair
Yogev, 2004130UnclearYesYesNoNoYesYes/YesFair
Zelop, 1999131YesYesYesNoNoYesNo/NoFair
Zelop, 2000132YesUnclearNoNoYesYesNo/NoPoor*
Zelop, 2001133YesYesYesNoNot applicableYesYes/YesFair

Quality Ratings of Case-Control Studies

Study, YearExplicit definition of casesDisease state of the cases similar & reliably assessedCase ascertainment reliable, valid & applied appropriatelyNonbiased selection of controlsCases/controls:comparable confounding factorsStudy procedures applied equallyAppropriate attention to confounders (consider & adjust)Appropriate statistical analysis used (matched, unmatched, overmatching)Quality Score
Adair, 1995134YesUnclearUnclearNoNoUnclearYes/NoUnmatchedPoor*
Bashiri, 20089YesUnclearNoYesNoNoUnclearOvermatchedPoor*
Bodelon, 2009135YesYesUnclearYesNoUnclearYes/YesUnclearFair
Buhimschi, 2005136YesYesYesYesYesYesNo/NoYesGood
Gilliam, 2002137YesYesNoYesNoYesYes/YesYesFair
Guihard, 2001138YesYesYesUnclearUnclearYesYes/YesYesFair
Hadley, 1986139SomewhatYesYesYesNoYesNANoPoor*
Juntunen, 2004140YesUnclearYesUnclearUnclearYesNo/NoUnclearFair
Kacmar, 2003141YesYesUnclearYesNoYesYes/YesUnclearFair
Laughon, 2005142YesYesYesYesNoYesYes/YesUnclearFair
Leung, 1993143YesYesUnclearYesUnclearUnclearNo/NoYesFair
Macones, 2001144YesYes/NoYesNoYesYes/NoYes/YesYesFair
Macones, 200581YesYesNoUnclearUnclearYesYes/UnclearSome. 4:1 matchingFair
Macones, 2006145YesYesYesYesNoYesYes/YesYes. No matchingGood
McMahon, 1997146YesUnclear. Used birth certificate data for previaUnclearYesNoUnclearNo/NoUnclearPoor*
Miles, 2000147YesYesUnclearNoUnclearUnclearSome/NoYesPoor*
Pickhardt, 1992148YesYes/NoYes/NoNoYesYes/NoYesYesFair
Rochelson, 2005149YesYesYesUnclearMatched on # prior cesarean otherwise non-matchedYesNo/NoYesPoor*
Rouse, 2006150YesYesUnclearUnclearNoUnclearYes/YesUnclearFair
Seidman, 1994151YesYesUnclearUnclearNoUnclearYes/YesUnclearPoor*
Shimonovitz, 2000152NoUnclearNoYesYesUnclearUnclearUnclearFair
Shipp, 2003153YesYesYesYesYesYesYes/YesYesGood
Tikkanen, 2006154YesUnclearNoNoNoUnclearYes/YesUnclearPoor*
Uygur, 2005155YesYesYesNoNoYesNo/NoUnclearPoor*
Uygur, 2005156YesUnclearNoNoYesNo/NoUnclearPoor*
Wu, 2005157YesYesNoYesNoUnclearYes/YesUnclearFair

Quality Ratings of Case Series Studies

Study, YearRepresentative sample selected from a relevant populationExplicit definition of casesSufficient description of distribution of prognostic factorsFollow-up long enough for important events to occurOutcomes assessed using objective criteria/blinding usedQuality Score
Armstrong, 2004158YesYesYesYesUnclearFair
Asakura, 2000159UnclearYesYesYesSome/NoFair
Blanco, 1992160YesYesNoYesNoFair
Bujold, 2002161YesYesYesYesNoFair
Chilaka, 2004162YesYesUnclearYesNoFair
Gotoh, 2000163NoNoYesYesYesFair
Grobman, 2007164YesYesYesYesUnclearGood
Kieser, 2002165YesYesYesYesYes/NoGood
Landon, 2005166YesYesYesYesUnclearGood
Leung, 1993167YesYesYesYesUnclearFair
Lynch, 2002168YesYesYesYesUnclearGood
Meehan, 1989169NRNRSomewhatYesNoFair
Mercer, 2008170YesYesYesYesUnclearGood
Raynor, 1993102YesYesNANAYesFair
Scott, 2001171YesYesYesYesUnclearPoor*
Sheiner, 2004172YesYesUnclearYesUnclearPoor*
Shellhaas, 2009YesYesYesYesUnclearGood
Shipp, 2002173YesYesSomewhatYesUnclearFair
Silver, 2006174YesYesYesYesUnclearGood
Stovall, 1987120YesYesNoYesUnclearPoor*
Yucel, 2006175]YesYesNoYesUnclearPoor*
Zelop, 1993176YesYesYesYesUnclearFair

Quality Ratings of Cohort Prediction Studies

Study, YearComparable Groups Clear inclusion and exclusion criteria for VBACMaintenance of comparable groupsClear definition of prognostic factorsMeasures reliable, validUnbiased assessment of data and analysis of resultsLoss/Drop-out rateFollow-up long enough for outcomes to occurAdjust for potential confounders (obstetric conditions)Quality Score
Bujold, 2001177NoNAYesYes/YesUnclearNAYesNoFair
Bujold, 200414YesNAYesYes/YesYesNAYesYesGood
Cameron, 2004178YesNAYesYes/YesNoNAYesYesGood
Chang, 200820YesNAYesYes/YesYesNAYesYesGood
Costantine, 2009179Yes. Unclear for twinsNAYesYes/YesNoNAYesYesGood
Dinsmoor, 200430YesNAYesYes/YesUnclearNAYesNoFair
Flamm, 199743YesNAYesYes/YesYesNAYesYesGood
Gonen, 2004180YesNAYesYes/YesUnclearNAYesYesGood
Grobman, 2007164YesNAYesYes/YesYesNAYesYesGood
Gyamfi, 2004181YesYesYesYes/YesUnclearNAYesYesGood
Harper, 2009182 (Macones 200581)YesNAYesYes/YesYesNAYesYesGood
Hashima, 200758No. Exclusion not definedNAYesYes/YesUnclearNAYesYesFair
Hendler, 2004183No. Exclusion not definedYesYesYes/YesUnclearNAYesYesGood
Huang, 2002184No. Exclusion not definedNAYesYes/YesUnclearNAYesYesFair
Hueston, 1994185No. Exclusion not defined. Unclear for twinsNANoYes/YesUnclearNAYesYesFair
Grobman, 2007164YesNAYesYes/YesYesNAYesYesGood
Jakobi, 1993186YesYesYesYes/YesNoNAYesYesGood
Kabir, 2005187YesNAYesYes/YesNANAYesYesGood
King, 1994188YesNAYesYes/YesUnclearNANAYesGood
Landon, 2005166YesNAYesYes/YesNoNAYesYesGood
Learman, 1996189YesNAYesYes/YesNoNAYesYesGood
Macones, 2001144Unclear how controls were selected.NAYesYes/YesUnclearNAYesYesFair
Macones, 200581YesNAYesYes/YesYesNAYesYesGood
McMahon, 199683YesYesYesYes/YesYesNAYesYesGood
Mercer, 2008170YesNAYesYes/YesNANAYesNoFair
Pang, 2009190YesYesYesYes/YesUnclearNAYesYesGood
Pickhardt, 1992148No. Exclusion not definedNANoYes/YesUnclearNAYesYesFair
Quinones, 200599YesNAYesYes/YesNoNAYesYesGood
Selo-Ojeme, 2008191No. Exclusion not definedNAYesYes/YesNoNAYesYesFair
Shipp, 2000192Unclear comparison between repeat CD and primary CDNAYesYes/YesYesNAYesYesFair
Smith, 2005193YesYesYesYes/YesNoNAYesYesGood
Spaans, 2002194YesNAYesYes/YesNoNAYesNoFair
Srinivas, 2007195YesYesYesYes/YesYesNAYesYesGood
Strong, 1996196No. Exclusion not definedYesYesYes/YesNoNAYesYesFair
Troyer, 1992197YesNAYesYes/NoUnclearNAYesNoFair
Vinueza, 2000198YesNAYesYes/NoNoNAYesUnclear for predictionFair
Weinstein, 1996127YesNAYesYes/YesUnclearNAYesYesGood

Poor quality studies are not included in the narrative or synthesis of the final report, unless no studies of better quality were available for a given topic and/or key question.

Abbreviations: CD=cesarean delivery; ERCD=elective repeat cesarean delivery; VBAC=vaginal birth after cesarean


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