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Trade-offs in Clinical Policy Making
Neal V. Dawson, MD;
Louise S. Acheson, MD, MS
Arch Fam Med. 1997;6(2):127-128.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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THE ARTICLE from the American Academy of Family Physicians Vaginal Birth After Cesarean Section (VBAC) policy team in this issue of the ARCHIVES1 adds an important analysis to the growing body of knowledge that for most patients a trial of labor (TOL) reasonably can be considered after a previous cesarean section (CS). Furthermore, after finding no difference in mortality or serious neonatal morbidity when comparing TOL with elective repeat CS (ERCS), the policy team explicitly favors a pivotal role for the childbearing woman's preferences. As the authors indicate, inherent in the process of developing clinical policies and making clinical decisions are trade-offs among the available evidence about outcomes, the preferences of clinicians and patients, and the costs associated with different clinical actions. Not yet developed are satisfying techniques for assigning value to each so that they can be compared or combined.
See also page 120
Even "evidence-based" policies
. . . [Full Text PDF of this Article]
Author Affiliations
Case Western Reserve University Cleveland, Ohio
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