Cardiotocography v Doppler auscultation

doi:10.1136/bmj.324.7335.482

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 developedthe guideline of the National Institute for Clinical Excellence(NICE) on the use of electronic fetal monitoring.¹ One of thepotential benefits of guidelines is to highlight gaps in researchevidence. As part of the guideline development process we conducteda survey of maternity units in England and Wales to evaluate thecurrent 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 asuitable method of monitoring during labour. This recommendationwas based on the evidence from nine randomised controlled trialsthat have enrolled 18 000 and are included in three systematicreviews.¹ This conclusion was reached because screening withcontinuous electronic fetal monitoring should not be conductedin the absence of evidence of benefit. This . . . [Full text of this article]

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