Abstract:
:Evidence-based medicine, the new practice paradigm, is rapidly replacing medicine by authority, the traditional paradigm. In 1993, we introduced evidence-based practice into our Department of Obstetrics, Gynecology, and Reproductive Sciences at San Francisco General Hospital, University of California, San Francisco. We orient all fellows, residents, and students to new methods of clinical decision making that use formal rules of evidence. We changed the format of clinical conferences from didactic lectures to clinical problem-solving sessions using the evidence-based medicine approach. Useful resources include the Cochrane Pregnancy and Childbirth Database on computer; Epi Info, version 6, a public-domain software package for microcomputers; 24-hour access to free MEDLINE searches via the Internet; the ACOG Resource Center; ACOGNET; and several paperback texts on critical appraisal. Evidence-based medicine helps to level the intellectual playing field in an academic department. This approach directly improves patient care by placing practice on a more secure scientific foundation. Moreover, evidence-based medicine provides clinicians with the skills to practice safe and effective obstetrics and gynecology as practice evolves.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Grimes DAdoi
10.1016/0029-7844(95)00184-Ssubject
Has Abstractpub_date
1995-09-01 00:00:00pages
451-7issue
3eissn
0029-7844issn
1873-233Xpii
0029-7844(95)00184-Sjournal_volume
86pub_type
杂志文章abstract:BACKGROUND:A rare complication of hysterectomy is the formation of a high-flow fistula between the uterine artery and uterine vein. Historically, these lesions were treated surgically. CASE:Two women with histories including hysterectomy presented with symptoms and physical examination signs suggestive of uterine arte...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181834660
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of device-guided slow-paced respiration for reducing the frequency and severity of menopausal hot flushes. METHODS:Perimenopausal or postmenopausal women reporting four or more hot flushes per day were recruited into a parallel-group, randomized trial of slow-paced respiration using ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0000000000000821
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To examine racial differences in hormone replacement therapy (HRT) use by analyzing the relative risks and rates of HRT prescriptions for black and white women. METHODS:Data on visits to hospital outpatient departments and office-based physicians by black and white women aged 45-64 years were obtained from 2...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00540-7
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To compare temporal trends of urogynecologic mesh medical device reports with sentinel U.S. Food and Drug Administration (FDA) notices and to examine all linked reports of patient death. METHODS:The Reed Tech Navigator is an online tool used to extract and analyze data in the Manufacturer and User Facility D...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003805
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of protein supplementation of culture media on reactive oxygen species production and incidence of apoptosis in preimplantation mouse embryos. METHODS:A total of 72 two-cell mouse embryos were cultured in human tubal fluid (HTF) alone (HTF-alone, control) and 71 embryos in HTF with pro...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000152384.91385.71
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:Emerging data suggest that oophorectomy at the time of hysterectomy for benign indications may increase long-term morbidity and mortality. We performed a population-based analysis to estimate the rates of oophorectomy in women undergoing hysterectomy for benign indications. METHODS:The Perspective database w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182887a47
更新日期:2013-04-01 00:00:00
abstract::Worldwide, sterilization (tubal sterilization and vasectomy) is used by more people than any other method of contraception. All techniques of tubal sterilization in widespread use in the United States have low risks of surgical complications. Although tubal sterilization is highly effective, the risk of pregnancy vari...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.AOG.0000298621.98372.62
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To compare persistent ectopic pregnancy after laparoscopic salpingostomy versus salpingostomy at laparotomy for the treatment of intact ampullary ectopic pregnancy. METHODS:We reviewed the medical records of 157 patients who had undergone salpingostomy for intact ampullary ectopic pregnancy at Yale-New Haven...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-03-01 00:00:00
abstract::Relaxin is a peptide hormone produced solely by the corpus luteum of pregnant women. Extracts of human pregnancy corpora lutea have relaxin activity in bioassay systems. This activity can be measured in a heterologous porcine radioimmunoassay (RIA). Immunoreactive relaxin was undetectable in the RIA in 51 nonpregnant ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract:OBJECTIVE:To examine the current patterns of care for women at high risk for delivery-related morbidity to inform discussions about the feasibility of this regionalized approach. METHODS:We performed a cross-sectional study and linked 2014 American Hospital Association survey and State Inpatient Database data from sev...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003397
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To determine the cure rate of urge incontinence after Burch colposuspension in patients with mixed incontinence diagnosed urodynamically, to determine if cure rates were different when the onset of urge symptoms antedated or postdated the symptoms of stress incontinence, and to propose appropriate preoperativ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00550-4
更新日期:1998-01-01 00:00:00
abstract::Although urine cultures are performed routinely in managing acute pyelonephritis in pregnancy, little is known about the clinical usefulness of these cultures. The same is true for blood cultures. To evaluate their role in managing patients, we reviewed the records of 156 cases to determine to what extent such culture...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:To examine differences in clinical and pathologic characteristics between women undergoing hysterectomy who had had prior tubal sterilization and those who had not. METHODS:One thousand eight hundred fifty-one women undergoing hysterectomy were enrolled as part of a multicenter, prospective cohort study. We ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0029-7844(96)00149-4
更新日期:1996-08-01 00:00:00
abstract::The outcome of delivery of infants weighing more than 4000 g born during two time periods 15 years apart was studied retrospectively. The increased use of cesarean section and other obstetric advances did not reduce the risk of fetal asphyxia and trauma associated with large fetal size. Maternal factors were identifie...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract:OBJECTIVE:To examine the histology of the vaginal wall in women with an enterocele confirmed by physical examination, cystoproctography, and intraoperative exploration. METHODS:Thirteen women with posthysterectomy apical and posterior wall prolapse were evaluated with a detailed physical examination, cystoproctography...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01524-1
更新日期:2001-10-01 00:00:00
abstract::The safety and efficacy of laminaria tents as an adjunct to labor induction near term were examined in a prospective, controlled, and randomized study involving insertion of laminaria into the cervical canal the evening prior to planned induction. Six of 35 subjects in whom laminaria were used entered labor spontaneou...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006250-197805000-00021
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVE:To investigate the value of the combined use of vaginal ultrasonography and endometrial sampling in the office for the diagnosis of endometrial disease in postmenopausal women. METHODS:One hundred forty consecutive postmenopausal women presenting with uterine bleeding or endometrial cells on cervical cytolog...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0029-7844(94)00421-9
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To determine whether there is an association between history of sexual abuse and development of chronic pelvic pain. METHODS:We studied 36 women with chronic pelvic pain, 23 with chronic low back pain, and 20 healthy women with reference to experience of sexual abuse, physical violence, and emotional neglect...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01072-3
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:Women with a history of preeclampsia have an increased risk of developing chronic hypertension and cardiovascular disease. However, little is known about the mechanism responsible for vascular disease in formerly preeclamptic women. The aim of our study was to test whether preeclampsia predisposes to central ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31819caf0f
更新日期:2009-04-01 00:00:00
abstract::Advances in the immunopathology of blistering diseases now provide increased accuracy in the diagnosis of herpes gestationis in pregnancy. Guidelines are presented in this review to determine the presence of the disease. Exogenous corticosteroids will effectively alleviate symptoms and prevent formation of new lesions...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-06-01 00:00:00
abstract:OBJECTIVE:To estimate the frequency of mismatch repair deficiencies associated with hereditary nonpolyposis colorectal cancer, or Lynch syndrome, in women less than age 50 with endometrial cancer. METHODS:Consecutive patients less than age 50 diagnosed with endometrial adenocarcinoma were identified. Available patholo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31817051d9
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To estimate normal ranges for postpartum maternal vital signs. METHODS:We conducted a multicenter prospective longitudinal cohort study in the United Kingdom. We recruited women before 20 weeks of gestation without significant comorbidities and with accurately dated singleton pregnancies. Women recorded thei...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004239
更新日期:2021-02-01 00:00:00
abstract::Seventy-five high-risk pregnancies were studied in order to define the clinical value of the analysis of fetal blood flow velocity waveforms in early screening for growth retardation. Recordings were obtained at 26-28 weeks' gestation, in the absence of ultrasonographic signs of growth retardation, using a pulsed dupl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:To assess the association of a first-trimester subchorionic hematoma with pregnancy loss in women with singleton pregnancies. METHODS:We conducted a retrospective cohort study of all women with singleton pregnancies presenting for prenatal care before 14 weeks of gestation over a 3-year period at a single ob...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003360
更新日期:2019-08-01 00:00:00
abstract::Information from vital records is critical to identify and quantify health-related issues and to measure progress toward quality improvement and public health goals. In particular, maternal and infant mortality serve as important indicators of the nation's health, thereby influencing policy development, funding of pro...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0000000000001050
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:To evaluate an interferon (IFN)-gamma release assay in diagnosing latent tuberculosis infection in pregnant adolescents and women at risk for exposure to Mycobacterium tuberculosis. METHODS:This was a prospective study of women and adolescents receiving health care at Bellevue Hospital Outpatient Clinics in ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0b013e3182546aff
更新日期:2012-06-01 00:00:00
abstract::Obesity is a medical condition that may be associated with bias among health care professionals, and this bias may result in disrespectful or inadequate care of patients with obesity. Obstetrician-gynecologists regularly care for patients with obesity and play an integral role in advocating for best practices in healt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000003015
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Uterine leiomyosarcoma is an aggressive tumor that has a propensity for distant metastasis. Distant sites of spread include the lung, liver, brain, and bone. CASE:A woman in her 5th decade was diagnosed with stage IV leiomyosarcoma of the uterus. Distant metastasis in the chest was confirmed by thoracotomy ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02191-9
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the cumulative probability of regret after tubal sterilization, and to identify risk factors for regret that are identifiable before sterilization. METHODS:We used a prospective, multicenter cohort study to evaluate the cumulative probability of regret within 14 years after tubal sterilization. P...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0029-7844(98)00539-0
更新日期:1999-06-01 00:00:00
abstract::An unusual case is presented of advanced dysgerminoma in a patient with Swyer syndrome, 46,XY pure gonadal dysgenesis. Unexpected regional invasion necessitated bowel resection, total abdominal hysterectomy, and bilateral salpingogonadectomy for a complete en bloc excision of the primary tumor mass and the dysgenetic ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00