gms | German Medical Science

Background: Many midwives are aware of evidence from reviews, such as those from the Cochrane Collaboration. But they are asking themselves if they can transfer these results to their every-day work and how they should handle results that do not (yet) indicate a preference for one of the interventions examined.

Objective: The question arises, for example, if the study population is comparable to the parents-to-be in the midwives’ practice or if the interventions presented correspond to the ones the midwives use. Therefore, a method should be elaborated as to how a midwife can assess whether the recommendations of a review indicate the best way for her own practice.

Aim: This method seeks to support the decision-making process of a midwife and to contribute to the transferability of scientific evidence.

Methodology: On the basis of existing theoretical frameworks, a method is developed as to how scientific evidence can be validated for every-day work. To achieve this aim, the method is first substantiated on a theoretical basis and then tested with the help of different simulation scenarios: Intervention 1 in this context is defined as the more successful one and intervention 2 as the less successful one, with each outcome being measurable relatively short-term. Their rates of success are then slotted on different levels (in lower and higher ranges of percentage) and set up with two differences between the rates (17 and 5 percentage points). The initial interventions (1 or 2) are alternated. This method is based on the work of Beck-Bornhold und Dubben [1] who refer to the efforts of Thomas Bayes (1702 - 1761) and Herman Ole Andreas Wold (1908 - 1992) [2]. The main principle states that a switch to the alternative intervention is necessary with the second patient if the initial intervention failed with the first one. If the alternative intervention shows no success, a changeover to the initial intervention is required. As a result, intervention rows of different lengths are being created. From the length of each row, the success rate can be established.

Results: This method rapidly leads to persuasive results. The lower the success rate and the higher the difference in success, the faster a clear preference can be demonstrated. Detailed results are pending and will be presented at the conference.

Relevance: This method helps to apply scientific evidence to a particular setting and supports the decision-making process in midwifery practice in cases of inconclusive evidence.

Recommendations/conclusions: The results can serve as basis for discussion of this method and its applicability.

Ethical considerations: If this method is considered useful, it could be a reliable way of integrating current scientific evidence into midwifery practice. As the method stipulates a change of intervention in case of failure, the families in a midwifery practice will always receive the best treatment according to the existing level of evidence.