"Some methodological problems" indeed - the understatement of the month - but correct in observation of the profound impact that trial has had despite those problems, and without examining why. As Sir Francis Bacon said long ago, "People believe what they would rather believe". Without editorializing further, you might as well add to the list ritual induction of labour at 41 weeks amenorrhea (three days past the median and mode) based on the trial from the same sources published in NEJM 1992 (326:1587-92), and ensuing Cochrane metaanalysis.
PFH
Philip F. Hall, MD BScMed FRCSC
Professor, Faculty of Medicine, University of Manitoba
Director, Fetal Assessment, Manitoba Obstetric Outreach and Maternal-Fetal Medicine Programs
Vice President, Medical Staff
St.Boniface General Hospital, 409 Tache Avenue D2044
Winnipeg, Manitoba, Canada R2H 2A6
ph 204-237-2547 FAX 204-233-1751
(Past Chair, Obs & Gyn Specialty Committee,
Royal College of Physicians & Surgeons of Canada)
<www.umanitoba.ca/womens_health>
>>> Paul Flynn <[log in to unmask]> 11/04/03 04:34PM >>>
Hi Ben,
Some suggestions for your collection:
Term Breech Trial
"Planned caesarean section versus planned vaginal birth for breech
presentation at term: a randomised multicentre trial " The Lancet 2000;356:
1375-83.
This study, despite some methodological problems, has drastically changed
the management of breech presentation.
>>>Mr. Paul M Flynn MRCOG
Consultant Gynaecologist, Singleton Hospital, Swansea, SA2 8QA, UK
+44 1792 285314 Fax: +44 7092 173892
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