ABSTRACT
Sackett (1996) is credited with bringing it to our attention in his seminal paper in the British Medical Journal. Pope (2003) traces its epidemiological roots, characterising it as a social movement whose spread in western health care has been remarkable since the mid 1990s. Large sections of the health professions, health care managers and finally governments themselves have embraced it with an almost evangelistic fervour. Rather simplistic slogans have trumpeted its common sense appeal. ‘Doing the right thing, in the right way at the right time to the right patient’ was one nursing rendition of its intent (RCN 1998). Others have simply stated that it is about doing what works, what is effective. Premised on research, specifically the randomised controlled trial (RCT), evidence-based care is care that is shown to be effective in trials of target populations. Maternity services were ahead of the game here due to the development in the late 1980s of the Cochrane Database (Chalmers et al. 1989). It had championed the value of systematic reviews (the aggregating of results from several RCTs) to produce convincing results of the effectiveness of various treatments, enhancing their generalisability to other populations of patients.
