The burden of illness in perinatal and neonatal care: the epidemiologist's role.
Clinical research to improve outcomes of pregnancy and perinatal/neonatal care and to reduce the burden of illness is grounded in modern principles of evidence-based clinical practice. The central tool for creating convincing evidence is the randomised controlled trial (RCT). However, creating evidence is only one step to the overall goal of reducing the burden of illness. Once new evidence has been created by a RCT it must be synthesised with existing evidence, the evidence must be applied and disseminated into clinical practice, and the effect of the new evidence on the specific illness being targeted must be re-evaluated. Perinatal/neonatal epidemiologists require multiple skills to understand not only how to evaluate the burden of illness and to identify problems that might have solutions, but also how to create and synthesise evidence, apply it in practice and evaluate its clinical application, even though they need not be equally expert in all areas.
Doyle
Lex W
LW
Department of Obstetrics & Gynaecology, The Royal Women's Hospital, 132 Grattan St, Carlton, Victoria 3053, and University of Melbourne, Melbourne, Australia. lwd@unimelb.edu.au
D017281:Cost of Illness; D004813:Epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control; D015931:Intensive Care, Neonatal; D018743:Perinatal Care; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic