Alejandro R, Jadad MD, Enkin MW, 2nd Edition. Oxford: Blackwell Publishing Limited; 2007

Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D, Stroup DF Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996; 276:(8)637-9

Chalmers I Applying overviews and meta-analysis at the bedside. J Clin Epidemiol. 1995; 48:67-70

Chan AW, Hrobjartsson A, Haahr MT, Gotzsche PC, Altman DG Empirical evidence for selective reporting of outcomes in randomized trials: comparison of protocols to published articles. JAMA. 2004; 291:2457-65

Critical Appraisal Skills Programme. CASP. 2015. (accessed 17 March 2015)

Dickersin K, Chan S, Chalmers TC, Sacks HS, Smith H Publication bias and clinical trials. Control Clin Trials. 1987; 8:343-53

Downe S, Gerrett D, Renfrew M A prospective randomised trial: the effect of position in the passive second stage on birth outcome in nulliparous women using epidural analgesia. Midwifery. 2004; 20:(2)157-68

Dwan K, Altman DG, Arnaiz JA, Bloom J, Chan AW, Cronin E Systematic reviewof the empirical evidence of study publication bias and outcome reporting bias. PLoS One. 2008; 3

Enkin M, Keirse MJNC, Chalmers IOxford: Oxford University Press; 1989

Hahn S, Williamson PR, Hutton JL Investigation of within-study selective reporting in clinical research: follow-up of applications submitted to a local research ethics committee. J Eval Clin Pract. 2002; 8:353-9

Hutton JL, Williamson PR Bias in meta-analysis due to outcome variable selection within studies. Appl Stat. 2000; 49:359-70

Kirkham JJ, Dwan KM, Altman DA, Gamble C, Dodd S, Smyth RMD The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews. BMJ. 2010; 340

Lavender T, Alfirevic Z, Walkinshaw S Partogram action line study: a randomised trial. Br J Obstet Gynaecol. 1998; 105:(9)976-80

Lavender T, Bedwell C, Tsekiri-O'Brien E, Hart A, Turner M, Cork M A qualitative study exploring women's and health professionals' views of newborn bathing practices. Evidence Based Midwifery. 2009; 7:(4)112-21

Lavender T, Furber C, Campbell M, Victor S, Roberts I, Bedwell C, Cork M Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor-blinded randomised controlled equivalence trial. BMC Pediatr. 2012; 12

Lavender T, Bedwell C, Roberts SA, Hart A, Turner MA, Carter L-A, Cork MJ Randomized, controlled trial evaluating a baby wash product on skin barrier function in healthy, term neonates. J Obstet Gynecol Neonatal Nurs. 2013; 42:(2)203-14

Lyndon-Rochelle M, Hodnett E, Renfrew M, Lumley J A systematic approach for midwifery students. MIDIRS Midwifery Digest. 2003; 13:(4)454-5

Muir Gray JALondon: Churchill Livingstone; 1997

Owen R Reader bias. JAMA. 1982; 247:2533-34

Sackett DL, Rosenberg WM, Muir Gray JA Evidence based medicine: what it is and what it isn't. BMJ. 1996; 312:71-2

Smyth RM, Kirkham JJ, Jacoby A, Altman DG, Gamble C, Williamson PR Frequency and reasons for outcome reporting bias in clinical trials: interviews with trialists. BMJ. 2011; 342

Williamson PR, Gamble C, Altman DG, Hutton JL Outcome selection bias in meta-analysis. Stat Methods Med Res. 2005; 14:515-24

What constitutes good trial evidence?

02 May 2015
11 min read
Volume 23 · Issue 5


In this paper the authors will discuss the randomised controlled trial, in the context of evidence-based practice. This paper aims to provide clinical midwives with some insight into what makes a good trial paper, highlighting the main areas where there are often misunderstandings of the appropriateness of trial methodology within individual studies. Being able to determine what constitutes good trial evidence is important in determining which evidence should be applied to practice.

Evidence-based practice has been the mantra within health settings over the last 2 decades. It is a phrase that can be found in the majority of academic texts and assignments of most midwifery students. Several definitions have been proposed to describe evidence-based practice; the most often cited is that by Sackett et al (1996: 71), who stated that evidence-based health care is:

‘…the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients [women]. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.’

This definition includes the woman at the centre of care and integrates clinical expertise with the best available research evidence, making it appropriate for midwives. However, given the volume of evidence being produced through research and the limited resources and/or ability of some midwives to assess the research thoroughly, determining what the best evidence is can remain a challenge. Moreover, perhaps the over usage of the term ‘evidence-based practice’ as a blanket justification for the care provided, undermines the importance of determining what constitutes strong or poor evidence.

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