Hi Jenny

Thanks for mail.

I agree that those would be important indicators but unfortunately, the
recent Health Strategy published in Southern Ireland has minimal reference
to maternity care.  This is partly because a separate Plan for Women's
Health is due to be released next year but in the interim I am trying to
identify what appropriate indicators of success and safety outcomes are
appropriate?

Many thanks again

Declan

Declan Devane,
Doctoral Student,
School of Nursing and Midwifery Studies,
University of Dublin Trinity College,
Trinity Centre for Health Sciences Education,
St. James's Hospital,
Dublin 8.
Tel: 087 659 6923
Email: [log in to unmask]

*******************************************
Please note that electronic mail to,
from or within Trinity College may be
the subject of a request under the
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-----Original Message-----
From: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]]On Behalf Of
Jennifer Cameron
Sent: 19 October 2002 01:02
To: [log in to unmask]
Subject: Re: sample size


Hi Declan
Look at the competency standards for midwifery practice and the clinical
indicators that your government health service uses to measure saferty and
quality in maternity care. Gretings from Australia.
Jenny Cameron
Midwife Educator/Practitioner
----- Original Message -----
From: "ddevane" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, October 18, 2002 10:54 PM
Subject: Re: sample size


> Hi Helen
>
> Yes, I have these studies and they are very helpful but there is still
this
> difficulty of selecting an outcome and then relating this outcome to
safety
> (I hope I am making sense?)
>
> Nevertheless, thanks for taking the time.
>
> Declan
>
> Declan Devane,
> Doctoral Student,
> School of Nursing and Midwifery Studies,
> University of Dublin Trinity College,
> Trinity Centre for Health Sciences Education,
> St. James's Hospital,
> Dublin 8.
> Tel: 087 659 6923
> Email: [log in to unmask]
>
> *******************************************
> Please note that electronic mail to,
> from or within Trinity College may be
> the subject of a request under the
> Freedom of Information Act
> *******************************************
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health
> research. [mailto:[log in to unmask]]On Behalf Of Helen
> Cheyne
> Sent: 18 October 2002 13:45
> To: [log in to unmask]
> Subject: Re: sample size
>
>
> Have you looked at the outcome measures of similar RCTs for example Vanora
> Hundley's study in Aberdeen or the Glasgow Royal Maternity RCT
>
> Turnbull et al (1996) Randomised controlled trial of efficacy of
> midwife-managed care. Lancet 348: 213-218
>
> Hundley et al (1994) Midwife managed delivery unit: a randomised
controlled
> comparison with consultant care. British Medical Journal. 309: 1400-1404.
>
> There are of course others and they should give you somewhere to start
>
> Helen Cheyne
>
> -----Original Message-----
> From: ddevane [mailto:[log in to unmask]]
> Sent: Friday, October 18, 2002 1:24 PM
> To: [log in to unmask]
> Subject: sample size
>
>
> Dear all,
>
> I am trying to estimate sample size for an RCT comparing midwifery-led
units
> to consultant-led care and have come across an ambiguous difficulty and
it's
> not related to estimating sample size with power analyses!
>
> I am aware that the primary question is what the sample size is based on.
> The main outcome of investigation of the trial is safety but this causes
> difficulties.  Maternal mortality is non runner as it is so rare in excess
> of 269,000 women would be needed to link causality and the same argument,
> although a smaller sample would be needed, is used in regard to neonatal
> mortality.  So we are left with morbidity outcome measures as a measure of
> safety and a decision as to which to choose as the primary question.
> Admission of babies to neonatal intensive care units is impractical
because
> to show a difference between 8% and 6% admitted would require in excess on
> 6000 women to be randomised.  Safety is certainly important but a broad
> concept but which outcome should be chosen.  Most importantly, I want to
> choose an outcome that is realistically achievable within the RCT.
Perhaps
> I should look at other outcome measures that are important and more common
> and would any of these be regarded as addressing 'safety'?
>
> Thanks for advice
>
>
> Declan
>
> Declan Devane,
> Doctoral Student,
> School of Nursing and Midwifery Studies,
> University of Dublin Trinity College,
> Trinity Centre for Health Sciences Education,
> St. James's Hospital,
> Dublin 8.
> Tel: 087 659 6923
> Email: [log in to unmask]
>
> *******************************************
> Please note that electronic mail to,
> from or within Trinity College may be
> the subject of a request under the
> Freedom of Information Act
> *******************************************
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