We reported the results of this meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline (Additional file 1 research checklist).
We searched Web of Science, PubMed, and Google Scholar databases. The terms for the search were pre-defined for a comprehensive search strategy. These included all fields within records and Medical Subject Headings (MeSH terms). In the Boolean operator, within each axis, we combined keywords with the “OR” operator. Then we linked the search strategies for the two axes with the “AND” operator. The search terms used for the search were “surgical case cancellation” OR “elective surgical case cancellation” AND “prevalence” OR “magnitude” AND reasons of surgical case cancellation AND “Ethiopia”. The specific searching detail in PubMed with MeSH terms was (“magnitude of surgical case cancellation”[MeSH Terms] OR “magnitude of elective surgical case cancellation”[MeSH Terms] OR “surgical case cancellation”[MeSH Terms] OR “elective case cancellation”[MeSH Terms] AND “prevalence” [All Fields])OR “magnitude”[MeSH Terms] AND reasons of surgical case cancellation [All Fields]) AND (“Ethiopia”). The last literature search was performed on February 8, 2020. The publication year of the studies was not limited during the search.
We exported retrieved studies to Endnote version 7 (Thomson Reuters, London) reference manager to remove duplicated studies.
The retrieved articles were screened according to pre-defined inclusion and exclusion criteria. Discussion and/or involvement of the third reviewer resolved disagreements between two reviewers.
Included studies were 1) articles that reported about the prevalence of elective surgical case cancellation and/or reasons for elective surgical case cancellation.2) studies published in English, and 3) studies conducted in Ethiopia before 02/08/2020. We did not limit the publication year of studies during the search.
Articles available without full-text, qualitative studies, any reviews, commentaries, consultants’ corners, letters, and conference abstracts were excluded.
We used Joanna Brigg’s Institute (JBI) quality appraisal criteria. It is the assessment tool used to check the quality of each article. The tool consists of nine major items. The first item is appropriate to the sample frame. The second is the appropriate sampling technique. The third is the adequacy of the sample size. The fourth is a description of the study subjects and settings. The fifth is enough coverage of data analysis. The sixth is the validity of the method for identification of the condition. The seventh item is a standard and reliable measurement for all participants. The eighth is the appropriateness of statistical analysis. And the last item is adequacy and management of response rate. Studies considered low-risk when it would fit 5 or above quality assessment checklists.
Three authors extract the data. Data extracted from each article were first author, the geographical location of the study, publication year, study design, study population, sample size, the prevalence of and root causes for cancellation of elective surgery. Outcome measurement
This systematic review and meta-analysis have two outcomes. Firstly, to determine the prevalence of elective surgical case cancellation in Ethiopia calculated as dividing the number of elective surgical patients but whom surgical cases canceled to the total number of patients multiply by 100. A total number of patients refer to elective surgical patients in the study period. Secondly, to identify the root causes for elective surgical case cancellation.
The required data were collected using a Microsoft Excel 2010 workbook form. Then, the STATA Version11 software was used to analyze the data. we used a weighted inverse variance random-effects model to estimate the pooled prevalence. The I2 statistics was employed to assess the percentage of total variation across studies . I2 ≤ 25% suggested more homogeneity,25% < I2 ≤ 75% suggested moderate heterogeneity, and I2 > 75% suggested high heterogeneity. Egger’s regression test was also applied to assess publication bias . Furthermore, we carried out the subgroup analysis based on the root causes for elective surgical case cancellation.