ABSTRACT

This chapter outlines some key concepts of clinical epidemiology that a specialist registrar in obstetrics and gynaecology or senior house officer needs during training or when preparing for the MRCOG examination. Traditionally, medical practice was based on pathophysiological mechanisms of disease and the experience of authoritative experts. The term ‘evidence-based medicine’ was first coined by Gordon Guyatt around 1990 to describe the process of bringing critical appraisal of research evidence to the bedside and basing clinical decisions on clinical research evidence, clinical expertise and patients’ values. Clinical practice guidelines are defined by the Institute of Medicine as ‘statements that include recommendations intended to optimise patient care, that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options’. Effective Care in Pregnancy and Childbirth was the first attempt in medicine to look thoroughly for research evidence and systematically summarise the effect of treatments in a clinical area.