Article
Opportunities and limitations of the “gold standard” Cochrane Review in evidence-based midwifery care
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Authors
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Michaela Michel-Schuldt
- Ludwigshafen University of Business and Society, Ludwigshafen, Germany
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Evelyn Lesta
- Hannover Medical School (MHH), Midwifery Research and Education Unit, Hannover, Germany
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Marina Weckend
- School of Nursing and Midwifery, Edith Cowan University, Perth, Australia
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Ruth Martis
- Luebeck University, Luebeck, Germany
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Beate Ramsayer
- Liverpool John Moores University, Liverpool, United Kingdom
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Hanna Gehling
- Fulda University of Applied Sciences, Faculty of Health Sciences, Fulda, Germany
| Published: | February 7, 2024 |
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Outline
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Background: The Cochrane Database of Systematic Reviews is one of the largest and best-known collections of reviews of scientific evidence in health care. It is based on the results of studies that meet certain quality criteria and includes mainly randomized controlled trials (RCTs). These are considered the “gold standard” for assessing the effectiveness of an intervention or treatment and are ranked at the top of the evidence pyramid. In German-speaking countries, midwives and scientists use the Cochrane Library reviews as sources of high quality scientific evidence, and their dissemination is supported by the German Society for Midwifery Science (DGHWi). For example, the International Midwifery Science Section of the DGHWi has been collaborating with Cochrane Germany for several years: Section members regularly search current reviews for relevance to midwives and translate scientific abstracts.
Cochrane Methods responded to criticism of the methodological approach in the past with transparency and continuous methodological development. The question of clinical relevance and significance for the target population can also be a basic problem in some studies. Particularly in the field of midwifery science, RCTs have long been critically debated because they cannot adequately investigate many relevant questions.
Aim/objective: Due to the high importance of Cochrane Reviews, we want to ask the question: what are the possibilities and limitations of systematic reviews in midwifery science? In this context, we want to discuss, among other things, to what extent a hierarchization of evidence is useful.
Methodology: A short keynote presentation will provide insight into the methodology and evaluation of these reviews. This will serve as the basis for the subsequent moderated discussion session, to which we invite experts to address the topic.
Results: The oral contributions of participants will be recorded by members of the International Section and will be published in the Journal of Midwifery Science to stimulate a broader debate.
Relevance: Evidence-based midwifery care relies on critical review of scientific evidence, its generation and evaluation.
Recommendations/conclusion: Cochrane reviews make an essential contribution to the generation and provision of evidence for midwifery care. Consideration should be given to the possibilities and limitations of this methodology. The classification of an evidence hierarchy based on study types should be questioned.
Ethics and conflicts of interest: A vote on ethics was not necessary. The research was financed by own resources. There are no conflicts of interest.
