[Comments on a report by the BQS on obstetric quality indicators].
When re-evaluating an epidemiologically oriented BQS expertise concerning the quality indicators in obstetrics, we examined three essential methods in obstetrics to verify their scientific evidence and their clinical relevance. In doing so we ascertained that recording the fetal heart rate sub part, analysing fetal blood and determining the blood gas of the umbilical blood are entirely appropriate quality indicators during delivery from a clinical and medical point of view -- although to varying extents. Above all, these three indicators prove to be essentially better evidence-based than described in the BQS expertise. The search for an optimum of evidence-based data in medicine ends in certain fields such as, for example, in obstetrics there where no further randomized studies can be carried out for methodological or ethical reasons. This lack of evidence for the optimum grade I which can clearly be understood from an epidemiological point of view, however, should not lead to an evidence nihilism that fails to accept or admit existing evidence of the weaker grades II and III.
Butterwegge
M
M
Frauenklinik im Marienhospital Osnabrück. prof.butterwegge@mhos.de
Gonser
M
M
Roemer
V M
VM
D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000517:prevention & control; D005323:Fetal Monitoring / Q000379:methods* / Q000592:standards*; D005858:Germany / Q000453:epidemiology; D006077:Government Agencies; D006801:Humans; D009774:Obstetrics / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D012015:Reference Standards