Reviewer's report
Title:Management of abortion complications at a rural hospital in Uganda: A
quality assessment by criterion-based audit
Version:1Date:9 February 2015
Reviewer: Mandira Paul
Reviewer's report:
Major Compulsory
The manuscript is poortly structured, sloppy written and with little scientific value
in the current format.
The introduction does not cover the scope of the study, it uses old references
and fails to provide the reader with essential information to internalise the
findings.
There is very little written about misoprostol in the introduction. Ignoring
misoprostol as an essential part of PAC is very problematic.
The aim is poorly stated and followed by a confusing explanation of the methods
used. It is more a justification of the choice of method than an aim of a study.
The methodology should be introduced in the introduction, not in the aim and not
in the methods.
Methods
Needs subheadings, it is incredibly poor structured and difficult to follow. Look at
similar papers and try to structure accordingly to help the reader.
It does not convince me of the soundness of the methodology.
Was there any kind of power calculation of how much sample would be needed
to present sound data?
Why were there time contstraints? Was the study not planned?
The authors claim to have made CBA while in fact they have only completed half
the method, this is mentioned but conclusions are drawn as if the whole CBA
was conducted and hence the study is presented as if data was more sound than
it actually is.
Results
Need structuring, do not present irrelevant data such as percentages for one or
two women.
Data is poor.
If this data could be combined with qualitative interview of quality PAC it would
be of greater interest. Currently, I am unsure of its contribution. It could
potentially serve as a pilot study or a brief commentary on methodology of CBA
in a low-resource setting.
Discussion
Mainly a long list of limitations which makes me wonder why you carried out the
study in the first place.
The following discussion of results is not interesting nor scientifically relevant and
poorly written.
Conclusion needs to be tightened.
Minor Compulsory
The Abstract needs tightening, consider removing the decimals in the %'s.The
conclusion contains results.
The first sentence in the introduction is strange: complications to abortion is the
second most important cause - what is an important cause? Also, there are more
recent estimates available.
The definition of unsafe abortions have been updated with a comment (WHO
2014), it may be interesting to consider.
Is reference 11 correct on line 71?
The inclusion criteria are referred to before they are explained in the results
section (line 100)
Who carried out the vaginal examination (line 111).
On line 249 you mention that ultrasound is the golden standard, which is true to a
certain extent however there is enough litterature that establishes the
accurateness of bimanual examination combined with LMP to determine
gestational length, this statement is old fashioned.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests