%0 Journal Article
%T Is general inpatient obstetrics and gynaecology evidence-based? A survey of practice with critical review of methodological issues
%A Aamir T Khan
%A M Nauman Mehr
%A Anne-Marie Gaynor
%A Malcolm Bowcock
%A Khalid S Khan
%J BMC Women's Health
%D 2006
%I BioMed Central
%R 10.1186/1472-6874-6-5
%X The main diagnosis-intervention set was established for a sample of 325 consecutive inpatient admissions in 1998¨C99 in a prospective study in a UK tertiary care centre. A comprehensive literature search was conducted to obtain the evidence supporting the intervention categorised according to the following hierarchy: Grade A, care supported by evidence from randomised controlled trials; Grade B, care supported by evidence from controlled observational studies and convincing non-randomised evidence; and Grade C, care without substantial research evidence.Of the 325 admissions, in 135 (42%) the quality of care was based on Grade A evidence, in 157 (48%) it was based on Grade B evidence, and in 33 (10%) it was based on Grade C evidence. The patterns of care were not different amongst patients sampled in 1998 and 1999.A significant majority (90%) of obstetric and gynaecological care was found to be supported by substantial research evidence.The practice of medicine is underpinned by clinical experience, intuitive clinical reasoning and applied medical research. In recent times, there has been a shift towards evidence-based medicine (EBM) defined as the conscientious, explicit and judicious use of contemporary best research evidence in making decisions about the care of individual patients [1]. To what extent is this concept being applied in clinical practice? This approach gained significant momentum in the 1990's. In thoracic surgery 78% of patient care [2], in general medicine 82% [3], in general surgery 95% [4], in paediatric medicine 75% [5], in ophthalmology 77% [6], and in anaesthesia 97% [7] of care is purported to be evidence-based. No such evidence exists in obstetric and gynaecological care. Such evaluations are fraught with methodological difficulties, which to our knowledge have not been explored in the literature. We thus assessed the extent of evidence-based care in an inpatient obstetrics-gynaecological unit and generated examples of potential pitfalls in
%U http://www.biomedcentral.com/1472-6874/6/5