%0 Journal Article
%T Is it possible to estimate the minimal clinically important treatment effect needed to change practice in preterm birth prevention? Results of an obstetrician survey used to support the design of a trial
%A Sue Ross
%A Jill Milne
%A Shannon Dwinnell
%A Selphee Tang
%A Stephen Wood
%J BMC Medical Research Methodology
%D 2012
%I BioMed Central
%R 10.1186/1471-2288-12-31
%X Questionnaires were mailed to practicing obstetricians, asking the magnitude of pregnancy prolongation required to introduce treatments into practice. The three prophylactic treatments were of increasing invasiveness: vaginal progesterone, intramuscular progesterone, and cervical cerclage. We also asked about the perceived most relevant outcome measures for obstetrical trials and current obstetrical practice in preterm birth prevention.544/1293(42.1%) completed questionnaires were received. The majority of respondents required one or two weeks' increase in length of gestation before introducing vaginal (372,77.1%), and intramuscular progesterone(354,67.9%). At least three weeks increase was required before introducing prophylactic cervical cerclage(326,62.8%). Clinicians who already used a treatment required a smaller difference before introducing it into practice. Decreasing neonatal morbidity was cited as the most important outcome for obstetrical trials (349,72.2%).Obstetricians would require a larger increase in treatment effect before introducing more invasive treatments into practice. Although infant morbidity was perceived as a more important outcome, clinicians appeared willing to change practice on the basis of prolongation of pregnancy, a surrogate outcome. We found that there is not a single minimum clinically important treatment effect that will influence all practising clinicians: rather the effect size that will influence physicians is affected by the nature of the treatment, the reported outcome measure and the clinician's own current clinical practice.Clinical practice should be guided by evidence from well designed clinical trials [1-3]. Unfortunately, the transfer of knowledge from research into practice is often challenging, with a concomitant delay in the uptake of new evidence [3,4]. Many reasons for the delay have been proposed, including the inadequate dissemination of research findings [5,6], and barriers caused by entrenched physician belief
%K Research design
%K Cross-sectional survey
%K Premature birth
%K Clinical trials as topic
%U http://www.biomedcentral.com/1471-2288/12/31