Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis

Background Mifepristone is a selective progesterone receptor modulator with decades of data demonstrating its potential as a highly effective emergency as well as non-emergency contraceptive. Despite considerable evidence pointing to the potential effectiveness of mifepristone as a non-emergency con...

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Main Authors: Kristina Gemzell-Danielsson, Rebecca Gomperts, Lisa Haddad, Miriam Nkangu, Caroline Frisendahl, Chelsea Polis, Tracy Chen, Evan Sterling, Marlena Plagianos
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e090402.full
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author Kristina Gemzell-Danielsson
Rebecca Gomperts
Lisa Haddad
Miriam Nkangu
Caroline Frisendahl
Chelsea Polis
Tracy Chen
Evan Sterling
Marlena Plagianos
author_facet Kristina Gemzell-Danielsson
Rebecca Gomperts
Lisa Haddad
Miriam Nkangu
Caroline Frisendahl
Chelsea Polis
Tracy Chen
Evan Sterling
Marlena Plagianos
author_sort Kristina Gemzell-Danielsson
collection DOAJ
description Background Mifepristone is a selective progesterone receptor modulator with decades of data demonstrating its potential as a highly effective emergency as well as non-emergency contraceptive. Despite considerable evidence pointing to the potential effectiveness of mifepristone as a non-emergency contraceptive, no systematic review has been conducted to synthesise the available evidence. This systematic review aims to synthesise the current evidence on the use of mifepristone as a non-emergency contraceptive to prevent pregnancy among cisgender girls and women of reproductive age.Methods We developed an electronic search strategy in collaboration with the research librarian. We will search five databases (Ovid Medline, CINAHL, EMBASE, Cochrane-Central Trials and Global Health) from inception and identify additional studies using several grey literature search strategies. All databases will be searched from inception, and we planned to complete the search by 30 June 2024. An Ovid Medline search strategy conducted on 24 May 2024 is provided as an example. We will include all studies that involve cisgender girls and/or women of reproductive age (defined as 54 years or younger), which assessed mifepristone as a non-emergency contraceptive to prevent pregnancy. The primary outcome is contraceptive effectiveness. Two independent reviewers will screen studies for eligibility through title, abstract, and full-text review. We will extract data with Covidence software using a Cochrane Effective Practice and Organisation of Care (EPOC)-adapted data-extraction tool and will assess risk of bias using the EPOC risk of bias tool and the Newcastle–Ottawa Scale. If sufficient data are available, we will conduct a meta-analysis using fixed and/or random effect models. However, if we are unable to conduct a meta-analysis, we will present the results narratively using the synthesis without meta-analysis guidelines and the EPOC table recommended for presenting findings without meta-analysis. Grades of Recommendation, Assessment, Development and Evaluation will be used to assess the quality of the evidence. We will report this review according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.Ethics and dissemination This review is focused on secondary data and does not require any ethical approval. We aim to publish the review in a peer-reviewed scientific journal to promote knowledge transfer and present results using other knowledge translation mediums.PROSPERO registration number CRD42024554720.
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spelling doaj-art-8664d8804cc84d239352bc6ddbcbb85b2024-12-16T17:25:10ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-090402Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysisKristina Gemzell-Danielsson0Rebecca Gomperts1Lisa Haddad2Miriam Nkangu3Caroline Frisendahl4Chelsea Polis5Tracy Chen6Evan Sterling7Marlena Plagianos83 WHO Collaborating Centre, Division of Neonatology, Obstetrics, Gynecology, and Reproductive Health, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden7 Women on Waves, Zuid-Holland, Netherlands2 Population Council Center for Biomedical Research, New York City, New York, USA1 University of Ottawa, Ottawa, Ontario, Canada3 WHO Collaborating Centre, Division of Neonatology, Obstetrics, Gynecology, and Reproductive Health, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden2 Population Council Center for Biomedical Research, New York City, New York, USA5 University of Hawai`i at Mnoa John A Burns School of Medicine, Honolulu, Hawaii, USA6 University of Ottawa Library, University of Ottawa, Ottawa, Ontario, Canada2 Population Council Center for Biomedical Research, New York City, New York, USABackground Mifepristone is a selective progesterone receptor modulator with decades of data demonstrating its potential as a highly effective emergency as well as non-emergency contraceptive. Despite considerable evidence pointing to the potential effectiveness of mifepristone as a non-emergency contraceptive, no systematic review has been conducted to synthesise the available evidence. This systematic review aims to synthesise the current evidence on the use of mifepristone as a non-emergency contraceptive to prevent pregnancy among cisgender girls and women of reproductive age.Methods We developed an electronic search strategy in collaboration with the research librarian. We will search five databases (Ovid Medline, CINAHL, EMBASE, Cochrane-Central Trials and Global Health) from inception and identify additional studies using several grey literature search strategies. All databases will be searched from inception, and we planned to complete the search by 30 June 2024. An Ovid Medline search strategy conducted on 24 May 2024 is provided as an example. We will include all studies that involve cisgender girls and/or women of reproductive age (defined as 54 years or younger), which assessed mifepristone as a non-emergency contraceptive to prevent pregnancy. The primary outcome is contraceptive effectiveness. Two independent reviewers will screen studies for eligibility through title, abstract, and full-text review. We will extract data with Covidence software using a Cochrane Effective Practice and Organisation of Care (EPOC)-adapted data-extraction tool and will assess risk of bias using the EPOC risk of bias tool and the Newcastle–Ottawa Scale. If sufficient data are available, we will conduct a meta-analysis using fixed and/or random effect models. However, if we are unable to conduct a meta-analysis, we will present the results narratively using the synthesis without meta-analysis guidelines and the EPOC table recommended for presenting findings without meta-analysis. Grades of Recommendation, Assessment, Development and Evaluation will be used to assess the quality of the evidence. We will report this review according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.Ethics and dissemination This review is focused on secondary data and does not require any ethical approval. We aim to publish the review in a peer-reviewed scientific journal to promote knowledge transfer and present results using other knowledge translation mediums.PROSPERO registration number CRD42024554720.https://bmjopen.bmj.com/content/14/12/e090402.full
spellingShingle Kristina Gemzell-Danielsson
Rebecca Gomperts
Lisa Haddad
Miriam Nkangu
Caroline Frisendahl
Chelsea Polis
Tracy Chen
Evan Sterling
Marlena Plagianos
Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis
BMJ Open
title Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis
title_full Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis
title_fullStr Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis
title_full_unstemmed Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis
title_short Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis
title_sort mifepristone as a non emergency contraceptive among women of reproductive age a protocol for systematic review and meta analysis
url https://bmjopen.bmj.com/content/14/12/e090402.full
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