NICE’s draft guideline on intrapartum careBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g4279 (Published 27 June 2014) Cite this as: BMJ 2014;348:g4279
- Daghni Rajasingam, consultant obstetrician,
- Kate Harding, consultant obstetrician
- 1Guys and St Thomas’ Hospital Foundation Trust, London SE1 7EH, UK
In March 2014 the National Institute for Health and Care Excellence (NICE) released for consultation a draft of its updated guideline on intrapartum care.1 Publication of the final version is scheduled for October this year.
Although this update has involved a broad group of professionals and lay people (appointed through a transparent process of competitive interview), the “collective clinical experience” of obstetric practice came from just three obstetricians and two midwives. The guideline includes over 300 recommendations, and the evidence published with the full guideline will provide clinicians with a comprehensive, quality assessed resource of clinical trials and expert discussion. NICE has followed the suggested presentation of recommendations by the GRADE Working Group. However, we are concerned that using the terminology “strongly recommend,” “consider,” or “offer” for each point rather than the previous grading system (A to D) could make it more difficult to judge the level of evidence underpinning each recommendation without reading the full guideline. Most clinicians will not have the time to do this given that the complete guideline has increased from 305 to 805 pages, and this …