Friday, November 21, 2008

Evidence Based Midwifery


hbacmama said...


Sarah Stewart said...

RCT - randomised controlled trial - considered to be gold standard of evidence.

I'm teaching evidence-based practice to senior students on Monday, and was looking at how I could jazz up my slides, which is why I developed this cartoon.

Have a look at this article on wikipedia which will tell you the levels of evidence ie RCT is 'best' evidence - my opinion as an 'expert' would be at the bottom of the levels of evidence:

Carolyn said...

What about individualised care?

Sarah Stewart said...

There's lots of things I could add to this cartoon but ran out of room. There are three frames to it - can you see them all? In the third frame, the woman is say "what about women's choice?"

hbacmama said...

hmmmmmm random controlled trials.
I have to say that I love and hate them. Depending on what they say. wink wink.It is interesting that you allude to them being the 'gold standard'... and yet here in North America (the USA in particular) the medical community will shred them to pieces when they come out in FAVOUR of vbac... The best was the one that showed elective cesarean complications.
Yeah, they totally HATED that one.
What about women's choice?
sigh... if only!
Evidence based medicine? whoa... that exists? sorry, feeling very cynical and horrified at the medical community lately!

Sarah Stewart said...

That's right - RCTs are only as good as the methodology and rigor with which they are carried out, which is one of the points I put across to students.

And then there's the attitudes and beliefs of the health practitioners themselves. The Breech Trial is a brilliant case in point. It was a flawed trial and has been pilloried in the medical press since, but it's impact has been globally so immense that it has pretty much done away with vaginal birth in developed countries.