Abstract
In this short article we explore some of the challenges faced by those conducting
randomised trials in obstetrics and gynaecology. We discuss the current status of
trials comparing induction of labour versus expectant management, so called ‘deliver
or delay’ trials. We consider the benefits of utilising routine data for collecting
trial outcome data. Although cluster trials can provide a useful methodology for answering
difficult questions, we illustrate with an example that cluster trials are at risk
of delivering a misleading result. We discuss the importance of long term outcomes
in randomised trials.
Keywords
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Further reading
- Placental growth factor testing to assess women with suspected pre-eclampsia: a multicentre, pragmatic, stepped-wedge cluster-randomised controlled trial.Lancet. 2019; 393: 1807-1818
- Labor induction vs. Expectant management of low-risk pregnancy.N Engl J Med. 2018; 379: 2278-2279
- The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting.BMJ. 2015; 350: h391
- Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomised trial.Lancet. 2018; 392: 1629-1638
- Placental growth factor testing in suspected pre-eclampsia.Lancet. 2020; 395: 335
Article info
Publication history
Published online: January 05, 2021
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
