title: Is general inpatient obstetrics and gynaecology evidence-based? A survey of practice with critical review of methodological issues.
abstract: BACKGROUND
  To examine the rates of evidence-supported care provided in an obstetrics-gynaecology unit.
  
  
  METHODS
  The main diagnosis-intervention set was established for a sample of 325 consecutive inpatient admissions in 1998-99 in a prospective study in a UK tertiary care centre. A comprehensive literature search was conducted to obtain the evidence supporting the intervention categorised according to the following hierarchy: Grade A, care supported by evidence from randomised controlled trials; Grade B, care supported by evidence from controlled observational studies and convincing non-randomised evidence; and Grade C, care without substantial research evidence.
  
  
  RESULTS
  Of the 325 admissions, in 135 (42%) the quality of care was based on Grade A evidence, in 157 (48%) it was based on Grade B evidence, and in 33 (10%) it was based on Grade C evidence. The patterns of care were not different amongst patients sampled in 1998 and 1999.
  
  
  CONCLUSIONS
  A significant majority (90%) of obstetric and gynaecological care was found to be supported by substantial research evidence.
authors.affiliation: Department of Obstetrics and Gynaecology, Birmingham Womens NHS Trust, UK. draamirk@hotmail.com
authors.forename: Aamir T
authors.initials: AT
authors.lastname: Khan
authors.forename: M Nauman
authors.initials: MN
authors.lastname: Mehr
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Gaynor
authors.forename: Malcolm
authors.initials: M
authors.lastname: Bowcock
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Khan