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Subject:

Re: Grading of midwifery evidence

From:

Maggie Banks <[log in to unmask]>

Reply-To:

A forum for discussion on midwifery and reproductive health research." <[log in to unmask]>

Date:

Fri, 30 Aug 2002 20:39:10 +1200

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (89 lines)

How wonderful to read your comments Denis.
It is the informal 'focus group' that I am involved with in our Collective
which provides so much 'evidence' - always called anecdote in other forums.
We need to reclaim it - perhaps ANECDOTE could stand for And Now Every-woman
Can Decide Her Own Trustworthy Evidence.
Evidential heresy? or midwifery claiming Her own!
regards
Maggie Banks

15 Te Awa Road, RD 3, Hamilton, New Zealand
Ph: 64 7 856 4612
Fax: 64 7 856 3070
Website at www.birthspirit.co.nz

----- Original Message -----
From: denis.walsh <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, August 30, 2002 7:03 PM
Subject: Re: Grading of midwifery evidence


> 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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