To my knowledge, this has not been sorted by official body's yet. There are
criteria around to address the robustness of qualitative research but these
do not then transfer into a hierarchy table which quantitative research has
to judge its generalisability. Qualitative research's applicability works
more intuitively - when you read it, it 'rings bells' for your practice
environment, gives you insights, challenges taken-for-granted assumptions
etc. In this way, it can be very relevant to your situation. I've seen its
relevance explored locally through a 'focus group' reflective activity where
group members read it in advance and then discuss its implications for their
practice situation. Hierarchy of evidence tables of quantitative research
can work very positively for midwifery practice - most notably with the EFM
NICE Guideline which recommended abandoning the admission trace because the
research design used in the original research came midway down the hierarchy
table ( a non-randomised cohort study I think). One problem with the
hierarchy table is that at the bottom comes professional expertise/opinion
when there are no studies, and this begs the question - which professional
group and who decides on expertise. The other is that a table suggests a
kind of objectivity and an apolitical process - not so as both the stages of
quantitative research and its application to practice are intensely
political processes.
Denis Walsh
Midwife,
Leicester
----- Original Message -----
From: "Sue Dennett" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, August 29, 2002 8:46 PM
Subject: Grading of midwifery evidence
> Hello all,
>
> A demoralised breast feeding co-ordinator came to me for advice today.
She
> has been asked to grade the level of evidence which support her latest 3
> policies -skin to skin, hypoglycaemia and bottle feeding.
>
> This brought an issue to a head for me - especially as we are also all
busily
> developing midwifery guidelines for antenatal and intrapartum care.
>
> I would be grateful to hear your opinions on grading midwifery research,
> especially when much of it is qualitative and, in most situations, not
> appropriate for RCTs. I do feel that many of us working within large NHS
> trusts will be increasingly faced with this issue especially when dealing
> with such bodies as CNST (clinical negligence scheme for trusts) and
others.
>
> I would be grateful for some advice or directions to useful literature.
>
> Best wishes
>
>
> Sue Dennett
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