BMJ 2002;324:482 ( 23 February )

Letters

Cardiotocography v Doppler auscultation

    Guidelines highlight gaps in research evidence
    Conclusions do not recognise difference between statistical and clinical significance
    All unbiased comparative studies should be published
    Trials are underpowered
    Evidence is not as good as NICE suggests
    Author of editorial's reply
    Authors of paper's reply

Guidelines highlight gaps in research evidence

The first 150 words of the full text of this article appear below.

EDITOR---The clinical effectiveness support unit of the Royal College of Obstetricians and Gynaecologists has recently developed the guideline of the National Institute for Clinical Excellence (NICE) on the use of electronic fetal monitoring.1 One of the potential benefits of guidelines is to highlight gaps in research evidence. As part of the guideline development process we conducted a survey of maternity units in England and Wales to evaluate the current use of electronic fetal monitoring in intrapartum care.2

The guideline recommends that in women who are healthy and have an uncomplicated pregnancy, intermittent auscultation is a suitable method of monitoring during labour. This recommendation was based on the evidence from nine randomised controlled trials that have enrolled 18 000 and are included in three systematic reviews.1 This conclusion was reached because screening with continuous electronic fetal monitoring should not be conducted in the absence of evidence of benefit. This . . . [Full text of this article]
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