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Re: ob profession (was postpartum intercourse)From: Robert J. Woolley (wooll005@gold.tc.umn.edu)Mon Jun 30 09:08:55 1997
In message <33B90AF5.225A@accessnv.com> writes: > And still there is no RCT to show that performance of episiotomy is an > indicator of obstetrical incompetence. I think it ironic that you > require RCTs as the basis for your conclusions in all your arguments, > yet for this one you have no proof only opinion to which you are > entitled. I think I have made my case: there is no RCT showing > performance of episiotomy is an indicator of obstetrical incompetence > but it is only your opinion. Thanks for the discussion. How, exactly, do you propose to define and measure "incompetence" in order to carry out your proposed RCT? The repeated suggestion makes me think you do not understand what can and cannot be measured and demonstrated by an RCT. However, we certainly can show that those physicians who have more favorable views toward epis do more of them, and those who do lots of episiotomies tend to be aggressively interventionist in other ways, too (forceps, c-sectoins, labor inductions, etc). BTW, you misrepresent me: I do not require RCTs for every conclusion I draw or every clinical judgment I make. They simply do not exist for many, many questions. However, you are arguing for ignoring a conclusion agreed on by several RCTs, and I have not heard you justify that position yet. Please proceed. I also have not yet heard you give your indications and reasons for doing episiotomies (probably because you know that the evidence does not support you, and you don't want this shown publicly). Your evasiveness is duly noted. ---------------------------------------------------------------------------
--------------------------------------------------------------------------- Bob Woolley -- --------------------------------------------------------------------------- St. Paul, Minnesota
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