Chauhan Suneet P, Berghella Vincenzo, Sanderson Maureen, Magann Everett F, Morrison John C
Division of Maternal-Fetal Medicines, Aurora Health Care, West Allis, WI, USA.
Am J Obstet Gynecol. 2006 Jun;194(6):1564-72; discussion 1072-5. doi: 10.1016/j.ajog.2006.03.001.
The purpose of this study was to review the American College of Obstetricians and Gynecologists practices bulletins to quantify the type of recommendations and references and determining whether there are any differences between obstetric and gynecologic bulletins.
All practice bulletins published from June 1998 to December 2004 were reviewed. Odds ratios and 95% confidence intervals were calculated.
The 55 practice bulletins contained 438 recommendations of which 29% are level A, 33% level B, and 38% level C. The 55 bulletins cite 3953 references of which 17% are level I, 46% level II, 34% level III, and 3% others. Level A recommendations were significantly more likely among the 23 gynecologic than 32 obstetric bulletins (37% versus 23%, odds ratios 1.95, 95% confidence intervals 1.28, 2.96). The study types referenced in obstetric and gynecologic bulletins were similar (P > .05 for comparison of levels I, II, and III and meta-analysis references).
Only 29% of the American College of Obstetricians and Gynecologists recommendations are level A, based on good and consistent scientific evidence.
本研究旨在回顾美国妇产科医师学会的实践公告，以量化推荐意见和参考文献的类型，并确定产科和妇科公告之间是否存在差异。
回顾了1998年6月至2004年12月发布的所有实践公告。计算了优势比和95%置信区间。
55份实践公告包含438条推荐意见，其中29%为A级，33%为B级，38%为C级。55份公告引用了3953篇参考文献，其中17%为I级，46%为II级，34%为III级，3%为其他。在23份妇科公告中，A级推荐意见的比例显著高于32份产科公告（37%对23%，优势比1.95，95%置信区间1.28，2.96）。产科和妇科公告中引用的研究类型相似（I级、II级和III级及荟萃分析参考文献的比较，P>.05）。
基于充分且一致的科学证据，美国妇产科医师学会的推荐意见中只有29%为A级。
