Citations 1
Evidence-based medicine in obstetrics: can levels B and C recommendations be elevated to level A recommendations?
Group:, For the Evidenced-Based Medicine Obstetric, Chauhan, Suneet P. , Assel, Barbara G., Baxter, Jason K. , Grobman, Robert, Berghella, Vincenzo , Scardo, James A., Magann, Everett F. , Group:, For the Evidenced-Based Medicine Obstetric, Chang, Eugene , Brost, Brian , Smith, James Andrew Buchan , Morrison, John C.
Obstetric Medicine | May 22, 2009 | Volume: 2 | Issue: 2 | Pages: 63-66
In this study, 65% (132/195) of level B/C obstetric recommendations are amenable to randomized clinical trials (RCTs) and seven were identified as most needed. The purpose of the survey was to evaluate levels B and C recommendations in obstetric practice bulletins (PBs) regarding the feasibility of performing RCT to elevate each subject to level A evidence. Eleven geographically dispersed physicians with experience in research reviewed levels B and C recommendations for the ethical and logistical feasibility of performing an RCT. In the 35 obstetric PBs, 195 level B/C recommendations were reviewed. The majority considered 47 (24%) topics unethical for an RCT and thought 16 (11%) did not need an RCT, thus leaving 132 (67%) levels B and C recommendations available for an RCT. Two-thirds of levels B and C recommendations in obstetric PB are amenable to RCTs and potentially becoming level A evidence.