Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/130947
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Type: Journal article
Title: The traffic light pilot study: assessing the level of evidence for interventions in obstetrics and gynaecology
Author: Chong, K.Y.
McDonald, R.J.
Fan, M.
Mol, B.W.
Citation: Journal of Obstetrics and Gynaecology, 2021; 41(7):1076-1079
Publisher: Taylor & Francis
Issue Date: 2021
ISSN: 0144-3615
1364-6893
Statement of
Responsibility: 
Krystle Y. Chong, Rebecca J. McDonald , Ming Fan and Ben W. Mol
Abstract: Evidence-based medicine tries to support clinicians through research, integrated with clinical skill and patient values. This pilot study aimed to assess appropriateness and level of evidence of current clinical practices, through evaluating availability and quality of guidelines. A prospective observational study in a large tertiary hospital network was performed, sampling diagnostic and therapeutic interventions in obstetrics and gynaecology. Interventions performed were justified against knowledge in the published literature, and guideline recommended practice. We collected 58 patient observations, 40(69%) in obstetrics, 18(31%) in gynaecology. There were local guidelines relevant in 52%, national in 22%, and international guidelines in 12%. In 50 interventions with available guidelines, 54% provided strong and clear recommendations for practice, and were supported by research-based knowledge. Similarly, 66% of encounters were thought to be in concordance with research-based knowledge. There was good concordance between interventions and guideline recommendations. However, half of guidelines reviewed had limited or no knowledge to justify their recommendations. IMPACT STATEMENT <b>What is already known on this subject?</b> Evidence based medicine should aim to improve patient outcomes. However, available trials assessing effectiveness of established practices suggest that they convey little to no benefit to patients. There remains a paucity of evidence for established practices in obstetrics and gynaecology <b>What do the results of this study add?</b> This pilot study assesses the usefulness of interventions in obstetrics and gynaecology and confirms the feasibility of collecting and coding our interventions and clinical practices with a traffic light system. <b>What are the implications of these findings for clinical practice and/or further research?</b> These findings demonstrate the feasibility of our traffic lights grading system within obstetrics and gynaecology. It demonstrates this method is useful to assess what knowledge base is guiding clinical practice, how well practice concords with guidelines and literature, as well as the presence and significance of any gaps in knowledge. These early findings will be used in an expanded study and have implications on the way healthcare effectiveness is evaluated, as well as reducing healthcare expenditure in obstetrics and gynaecology.
Keywords: Evidence-based medicine
Gynaecology*/standards
Hospital
Obstetrics and Gynaecology Department
Obstetrics*/standards
clinical decision-making
patient-centered care
practice guidelines as topic
Description: Published online: 18 Feb 2021
Rights: © 2020 Informa UK Limited, trading as Taylor & Francis Group
DOI: 10.1080/01443615.2020.1845635
Grant ID: http://purl.org/au-research/grants/nhmrc/1082548
Appears in Collections:Aurora harvest 4
Obstetrics and Gynaecology publications

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