Current Resources for Evidence‐Based Practice January/February 2012

Abstract

Published simultaneously in Journal of Midwifery & Women's Health, 57(1). As a central component of the Affordable Care Act (ACA), new health insurance plans will be required to cover preventive health services without cost sharing to plan members beginning on or after August 1, 2012. In response to this directive within the ACA, the United States Department of Health and Human Services (HHS) charged the Institute of Medicine (IOM) with conducting a comprehensive review of women's preventive health services and recommending those services deemed necessary for the health of women in the United States (Gee et al, 2011). The IOM is a non‐governmental, non‐profit agency representing the health arm of the National Academies. The IOM is often charged with answering pressing health and health care questions by providing the highest level of scientific evidence available (IOM, 2011a). For this review, the IOM committee of experts examined and drew recommendations from three independent agencies: the United States Preventive Services Task Force, the American Academy of Pediatrics’ Bright Futures, and the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. In developing the guidelines for HHS, the committee considered evidence‐based health services shown to improve well‐being and/or decrease the likelihood of targeted diseases or conditions (IOM, 2011b). Development of recommendations was guided by the best available evidence, previously identified health priorities, and the potential impact of the recommendations. Ultimately, eight specific clinical measures for improving the health of women through preventive services and health screenings were put forth to HHS by the IOM expert committee and unanimously adopted by the HHS. The accepted clinical measures are targeted toward the following: reducing sexually transmitted infections, cervical cancer, and human immunodeficiency virus infection; improving detection of gestational diabetes; improving breastfeeding initiation and continuation rates through comprehensive lactation support and counseling; screening and counseling for interpersonal and domestic violence; improving annual (at minimum) preventive well woman care; and reducing unintended pregnancy and promoting healthy birth spacing. To address a national unintended pregnancy rate estimated to be at 50% (Finer & Zolna, 2011), the HHS adopted the IOM expert committee recommendation that all women with reproductive capacity have access to contraceptive counseling and the full range of United States Food and Drug Administration (FDA)‐approved contraceptive and sterilization options with no out‐of‐pocket cost. A summary of the committee's recommendations with supporting evidence and the projected impact on women's health practitioners can be found in the recent article by Gee et al. (2011). The IOM committee also made recommendations for the process of periodic update and review of the recommended preventive services. Lastly, the IOM committee recommended the formation of an independent commission to support this process. The IOM's Clinical Preventive Services recommendations represent a historic shift in women's health policy focused on prevention rather than reaction and were built on the foundation of the best available scientific evidence. Finer, L.B., & Zolna, M.R. (2011). Unintended pregnancy in the United States: Incidence and disparities, 2006. Contraception, 84(5), 478‐485. Gee, R.E., Brindis, C.D., Diaz, A., Francisco, G., Gregory, K., Peck, M., & Reece, E.A. (2011). Recommendations of the IOM Clinical Preventive Services for Women Committee: Implications for obstetricians and gynecologists. Current Opinion in Obstetrics & Gynecology, 23. doi: 10.1097/GCO.0b013e32834cdcc6 Institute of Medicine. (2011a). About the IOM. Retrieved from http://www.iom.edu/About-IOM.aspx Institute of Medicine. (2011b). Clinical preventive services for women: Closing the gaps. Washington, DC: National Academy of Sciences. •Adjuvant chemotherapy for endometrial cancer after hysterectomy•Acupuncture for polycystic ovarian syndrome•Admission tests other than cardiotocography for fetal assessment during labor•Antibiotics for ureaplasma in the vagina in pregnancy•Biofeedback for pain management during labour•Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes•Different strategies for diagnosing gestational diabetes to improve maternal and infant health•Drug therapy for treating post‐dural puncture headache•Early removal versus expectant management of central venous catheters in neonates with bloodstream infection•Epidermal growth factor receptor blockers for the treatment of ovarian cancer•Evaluation of follow‐up strategies for patients with epithelial ovarian cancer following completion of primary treatment•Gonadotrophin‐releasing hormone agonist protocols for pituitary suppression in assisted reproduction•High dose versus low dose oxytocin for augmentation of delayed labour•Intermittent preventive treatment regimens for malaria in HIV‐positive pregnant women•Interventions for prevention and treatment of vulvovaginal candidiasis in women with HIV infection•Luteal phase support for assisted reproduction cycles•Metroplasty versus expectant management for women with recurrent miscarriage and a septate uterus•Newborn screening for homocystinuria•Nitric oxide donors for cervical ripening and induction of labour•Non‐pharmacological management of infant and young child procedural pain•Nutritional advice for improving outcomes in multiple pregnancies•Peritoneal drainage versus laparotomy as initial surgical treatment for perforated necrotizing enterocolitis or spontaneous intestinal perforation in preterm low birth weight infants•Statins for women with polycystic ovary syndrome not actively trying to conceive•Surgical repair of spontaneous perineal tears that occur during childbirth versus no intervention•Tocolytics for preterm premature rupture of membranes•Vaginal chlorhexidine during labour for preventing maternal and neonatal infections (excluding Group B Streptococcal and HIV) •Adjuvant progestagens for endometrial cancer•Amniotomy for shortening spontaneous labour•Antiretroviral therapy for prevention of HIV transmission in HIV‐discordant couples•Behavioral interventions to promote condom use among women living with HIV•Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes•Diaphragm versus diaphragm with spermicides for contraception•Fetal electrocardiogram (ECG) for fetal monitoring during labour•Granulocyte transfusions for neonates with confirmed or suspected sepsis and neutropenia•Immersion in water in labour and birth•Interventions for prevention of neonatal hyperglycemia in very low birth weight infants•Interventions for treatment of neonatal hyperglycemia in very low birth weight infants•Non‐steroidal anti‐inflammatory drugs for heavy bleeding or pain associated with intrauterine‐device use•Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants•Oral lactoferrin for the treatment of sepsis and necrotizing enterocolitis in neonates•Parenteral opioids for maternal pain management in labour•Pentoxifylline for treatment of sepsis and necrotizing enterocolitis in neonates•Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes•Treatments for iron‐deficiency anaemia in pregnancy•Venepuncture versus heel lance for blood sampling in term neonates•Vitamin A supplementation to prevent mortality and short‐ and long‐term morbidity in very low birthweight infants•Semen preparation techniques for intrauterine insemination Cochrane Reviews are available by subscription to The Cochrane Library, and review abstracts are available without charge. See http://www.thecochranelibrary.com •Accuracy of liver function tests for predicting adverse maternal and fetal outcomes in women with preeclampsia: a systematic review•Accuracy of the random glucose test as screening test for gestational diabetes mellitus: a systematic review•Bowel resection for deep endometriosis: a systematic review•Diagnostic accuracy of transabdominal ultrasound in detecting prenatal cleft lip and palate: a systematic review•Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta‐analysis•Foley catheter balloon vs locally applied prostaglandins for cervical ripening and labor induction: a systematic review and metaanalysis•Fosfomycin versus other antibiotics for the treatment of cystitis: a meta‐analysis of randomized controlled trials•Interventions at caesarean section for reducing the risk of aspiration pneumonitis•Interventions for nausea and vomiting in early pregnancy•Meta‐analysis of observational studies on the safety and effectiveness of robotic gynaecological surgery•Motivational interviewing for smoking cessation: a meta‐analytic review•Nifedipine in the management of preterm labor: a systematic review and metaanalysis•Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis•Partial breast irradiation or whole breast radiotherapy for early breast cancer: a meta‐analysis of randomized controlled trials•Preconception care for diabetic women for improving maternal and fetal outcomes: a systematic review and meta‐analysis•Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta‐analysis•Systematic review and narrative synthesis of the effectiveness of contraceptive service interventions for young people, delivered in educational settings•Technology‐enhanced simulation for health professions education: a systematic review and meta‐analysis•The accuracy of the procalcitonin test for the diagnosis of neonatal sepsis: a meta‐analysis•The effectiveness of walking as an intervention for low back pain: a systematic review•Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta‐analysis of effectiveness and complications DARE abstracts are available without charge at http://www.crd.york.ac.uk/crdweb/ Featured Review: Farrar, D., Duley, L., & Lawlor, D.A. (2011). Different strategies for diagnosing gestational diabetes to improve maternal and infant health. Cochrane Database of Systematic Reviews, Issue 10. Art. No. CD007122. doi: 10.1002/14651858.CD007122.pub2 Gestational diabetes mellitus (GDM), the most common metabolic complication of pregnancy, is diagnosed in approximately 7% of pregnancies. The incidence of GDM is rising, mostly due to the increasing prevalence of maternal obesity, and is associated with increased maternal and perinatal morbidity. Methods for detection (screening and diagnosis), optimal time of testing, and diagnostic criteria are currently being debated. Currently, the two most commonly used tests for diagnosing GDM are the three‐hour oral glucose tolerance test (OGTT) and the two‐hour 75g OGTT. Limitations to the most commonly used diagnostic tests are that they require maternal fasting, ingesting a glucose solution, and waiting two to three hours to complete blood testing. A number of alternative tests have been proposed for the diagnosis of GDM. The purpose of this systematic review was to compare alternative diagnostic tests aimed at diagnosing GDM, as well as evaluate their association with select maternal and neonatal outcomes and utilization of health care resources. All diagnostic tests for GDM were included in the literature search (e.g., random and fasting blood sugars, OGTT, food sources of glucose, and glycolated hemoglobin). Studies included pregnant women, regardless of risk for GDM, but excluded women who were diagnosed with diabetes before the most current pregnancy. Five trials with a total of 578 women met the criteria for inclusion in this review. Overall, studies were small, of questionable quality, with few primary outcomes (e.g., diagnosis of GDM with need for treatment by either diet alone or medication, mode of birth, macrosomia) or secondary outcomes (e.g., induction of labor, side effects of testing, testing compliance, women's experiences, birth trauma, neonatal hypoglycemia, long‐term outcomes, health care costs) reported. Only one study compared the use of a 75g OGTT with a 100g OGTT for diagnosis of GDM. While this study found women who were tested with the 75g OGTT were more likely to be diagnosed with GDM (RR [risk ratio] 2.55, 95% CI [confidence interval] 1.55‐6.75), none of the primary or secondary outcomes of interest were reported in this trial. None of the remaining studies that compared types of glucose drinks, as well as food sources of glucose with glucose drinks, reported on primary outcomes. Rather, they focused generally on the acceptability of the type of glucose. In conclusion, the evidence comparing different testing strategies for diagnosing GDM is incomplete and does not provide insight to remaining important clinical questions such as what is the best time in pregnancy to test women for GDM, and whether fasting prior to testing is advantageous for the diagnosis of GDM. In general, nearly all studies were unable to inform this systematic review's primary and secondary outcome measures. Since accurate identification of GDM is a prerequisite for treatment, further studies comparing diagnostic methods for GDM that examine accuracy, acceptability, cost, and health outcomes for the pregnant woman and her fetus are needed. Comment: Surprisingly few studies comparing diagnostic methods for GDM were found for this systematic review. Of note, in most studies, researchers used a pre‐specified diagnostic test rather than comparing diagnostic methods between groups. Determining the most accurate, timely, and best‐tolerated diagnostic method for patients is essential for accurate diagnosis of this common metabolic condition in pregnancy. Featured Review: Kim, S., Park, H., Lee, H., & Lee, H. (2011). Acupuncture for premenstrual syndrome: a systematic review and meta‐analysis of randomized controlled trials. British Journal of Obstetrics &Gynecology, 118(8), 899‐915. doi: 10.1111/j.1471‐0528.2011.02994.x The authors of this systematic review of the evidence on the efficacy of acupuncture for relief of premenstrual syndrome (PMS) noted that up to 18% of women of reproductive age experience PMS symptoms severe enough to warrant treatment. Because of the multi‐dimensional aspects of PMS, treatment is likely to include lifestyle changes, such as diet and exercise, in addition to cognitive behavioral or traditional pharmacologic therapies. Many women with PMS are likely to try complementary and alternative medicine (CAM) treatments such as herbal preparations, acupressure, or acupuncture. Studies in this review were included only if the study was a randomized controlled trial (RCT); women met the diagnostic criteria for PMS or premenstrual tension syndrome; the study compared needle acupuncture for one or more menstrual cycles with sham acupuncture, usual care, or no treatment; and the study reported changes or improvements in PMS symptoms as outcome measures. If any concomitant therapy (other than acupuncture) was given, it had to be given to both the acupuncture and control groups. Of the 50 identified studies, 10 met the inclusion criteria. All included studies were small with an average of 47 women per trial. The majority of studies employed traditional Chinese medicine (TCM) style acupuncture, with the remaining three studies using Korean acupuncture techniques. Of the 10 studies, six compared acupuncture with Western or Chinese medication, three used sham‐controlled acupuncture for comparison, and one had no treatment in the control group. Because two studies had a high attrition rate, pooled analyses were performed on only eight of the 10 RCTs and showed a significant benefit for acupuncture improving the symptoms of PMS. Of the three studies comparing acupuncture with sham‐acupuncture, only two studies were admitted for pooled analyses, as one of the sham‐controlled studies used acupuncture points considered to be ineffective in PMS. The pooled analyses favored acupuncture over sham‐acupuncture (RR[risk ratio] 5.99; 95% CI, 2.84‐12.66; P < 0.00001). Significant improvement in PMS symptoms was also noted in the only study comparing acupuncture to no treatment and in the study comparing acupuncture and medication versus acupuncture alone. Of the four trials comparing acupuncture versus medication (hormonal treatment with or without anxiolytics), all showed mild symptom improvement (RR1.49; 95% CI; 1.27‐1.74, P < 0.00001) favoring acupuncture over medication. In summary, the authors note that while the results appear promising, the results should be interpreted in the context of the small sample sizes of the trials, and the high risk for bias in the included studies. It is also important to note that the included studies varied in acupuncture style as well as outcome measures for PMS. Comment: The studies in the evidence review involved up to 30 acupuncture sessions over three menstrual cycles. While acupuncture shows promise as a CAM therapy for PMS, more high‐quality studies with low risk for bias are needed to strengthen the evidence. Future studies should include explicit diagnostic criteria for PMS, validated instruments to measure symptom relief, and consideration of the cost‐effectiveness of acupuncture. Featured Review: Academy of Breastfeeding Medicine. (2011). ABM clinical protocol #10: breastfeeding the late preterm infant (34(0/7) to 36(6/7) weeks gestation). Breastfeeding Medicine: The Official Journal of the Academy of Breastfeeding Medicine, 6(3), 151‐156. In this recently updated clinical guideline, the American Academy of Breastfeeding Medicine addressed management of common breastfeeding problems for the late preterm infant. The most recent version of the protocol has been expanded to included infants born a week earlier (34 0/7 weeks ‐34 6/7 weeks), reflecting the National Institute of Child Health and Human Development definition of a late preterm infant. An earlier version of the protocol encompassed infants born at 35 0/7 to 36 6/7 weeks’ gestation. The authors of this clinical guideline also noted that infants born at 37 0/7 through 37 6/7 weeks may be at risk for breastfeeding problems; therefore, the guidelines may be applicable to these infants as well. The primary purpose of this guideline is to heighten awareness of the potential difficulties around breastfeeding for late preterm infants and their mothers. By making providers aware of the potential problems for breastfeeding infants born at this early age, the hope is to reduce medical problems such as dehydration, weight loss, hypoglycemia, and hyperbilirubinemia in the late preterm infant. This clinical guideline is based on the following principles of care: optimal communication, assessment/reassessment, timely lactation support in the inpatient and outpatient setting, minimizing mother‐infant separation, prevention and prompt recognition of breastfeeding problems, education, and discharge planning and follow‐up care. Guidelines for implementation of care are outlined according to the inpatient (i.e., importance of pre‐written order sets, observation guidelines) and outpatient setting (i.e., optimal timing and content of follow‐up visits). Levels of evidence for each specific recommendation are provided and are based on the United States Preventive Services Task Force Quality of Evidence. Areas for future research are offered noting that more research is needed to establish the best methods for monitoring the late preterm infant in the first 24 hours of life for physiologic stabilization while supporting breastfeeding initiation. Comment: The Academy of Breastfeeding Medicine is an international organization of physicians dedicated to the promotion, protection, and support of breastfeeding and human lactation (Academy of Breastfeeding Medicine, 2011a). Additional protocols and position statements can be found at their Web site (Academy of Breastfeeding Medicine, 2011b). Academy of Breastfeeding Medicine. (2011). About ABM. Retrieved from http://www.bfmed.org/About/Default.aspx Academy of Breastfeeding Medicine. (2011). Statements and protocols. Retrieved from http://www.bfmed.org/Resources/Protocols.aspx •Ahmad, S. 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Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: Revised recommendations for the use of contraceptive methods during the postpartum period. Morbidity & Mortality Weekly Report, 60(26), 878‐883.•Chan, A.L.F., Leung, H.W.C., & Wang S‐F. (2011). Multivitamin supplement use and risk of breast cancer: A meta‐analysis. Annals of Pharmacotherapy, 45(4), 476‐484.•Chen, L., & Hu, R. (2011). Thyroid autoimmunity and miscarriage: a meta‐analysis. Clinical Endocrinology, 74(4), 513‐519. doi: 10.1111/j.1365‐2265.2010.03974.x•Clay, F.S., Walsh, C.A., & Walsh, S.R. (2011). Staples vs subcuticular sutures for skin closure at cesarean delivery: A metaanalysis of randomized controlled trials. American Journal of Obstetrics & Gynecology, 204(5), 378‐383.•Cobo, A., & Diaz, C. (2011). Clinical application of oocyte vitrification: a systematic review and meta‐analysis of randomized controlled trials. 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Smoking before the first pregnancy and the risk of breast cancer: A meta‐analysis. American Journal of Epidemiology, 174(4), 390‐402.•Devaney, S.A., Palomaki, G.E., Scott, J.A., & Bianchi, D.W. (2011). Noninvasive fetal sex determination using cell‐free fetal DNA: A systematic review and meta‐analysis. Journal of the American Medical Association, 306(6), 627‐636.•Di Renzo, G.C., Roura, L.C., Facchinetti, F., Antsaklis, A., Breborowicz, G., Gratacos, E.,…Ville, Y. (2011). Guidelines for the management of spontaneous preterm labor: Identification of spontaneous preterm labor, diagnosis of preterm premature rupture of membranes, and preventive tools for preterm birth. Practice guideline. Journal of Maternal‐Fetal & Neonatal Medicine, 24(5), 659‐667.•Dong, J‐Y, & Qin L‐Q. (2011). Dietary glycemic index, glycemic load, and risk of breast cancer: meta‐analysis of prospective cohort studies. Breast Cancer Research & Treatment, 126(2), 287‐294.•Dong J‐Y, Zhang L, He K, & Qin L‐Q. (2011). Dairy consumption and risk of breast cancer: a meta‐analysis of prospective cohort studies. Breast Cancer Research & Treatment, 127(1), 23‐31.•Fox, N. S., Saltzman, D. H., Roman, A. S., Klauser, C. K., Moshier, E., & Rebarber, A. (2011). Intravaginal misoprostol versus Foley catheter for labour induction: A meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 118(6), 647‐654.•Gardener, H., Spiegelman, D., & Buka S.L. (2011). Perinatal and neonatal risk factors for autism: A comprehensive meta‐analysis. Pediatrics,128(2), 344‐355.•George, A., Shamim, S., Johnson, M., Ajwani, S., Bhole, S., Blinkhorn, A.,… Andrews, K. (2011). Periodontal treatment during pregnancy and birth outcomes: A meta‐analysis of randomised trials. International Journal of Evidence‐Based Healthcare, 9(2),122‐147.•Groeneveld, E., Broeze, K.A., Lambers, M.J., Haapsamo, M., Dirckx, K., Schoot, B.C.,… IPD MARIA Study Group. (2011). Is aspirin effective in women undergoing in vitro fertilization (IVF)? Results from an individual patient data meta‐analysis. Human Reproduction Update, 17(4), 501‐509.•Hackney, D.N., & Glantz, J.C. (2011). Vaginal bleeding in early pregnancy and preterm birth: Systemic review and analysis of heterogeneity. Journal of Maternal‐Fetal & Neonatal Medicine, 24(6), 778‐786.•Hemmi, M.H., Wolke, D., & Schneider, S. (2011). Associations between problems with crying, sleeping and/or feeding in infancy and long‐term behavioural outcomes in childhood: A meta‐analysis. Archives of Disease in Childhood, 96(7), 622‐629.•Henry, E.B., Patterson, C.C., & Cardwell, C.R. (2011). A meta‐analysis of the association between pre‐eclampsia and childhood‐onset Type 1 diabetes mellitus. Diabetic Medicine, 28(8), 900‐905.•Houssami, N., Ciatto, S., Turner, R.M., Cody, H.S., & Macaskill, P. (2011). Preoperative ultrasound‐guided needle biopsy of axillary nodes in invasive breast cancer: Meta‐analysis of its accuracy and utility in staging the axilla. Annals of Surgery, 254(2), 243‐251.•Kawai, K., Spiegelman, D., Shankar, A.H., & Fawzi, W.W. (2011). Maternal multiple micronutrient supplementation and pregnancy outcomes in developing countries: Meta‐analysis and meta‐regression. Bulletin of the World Health Organization, 89(6), 402‐411B.•Kjerulff, L.E., Sanchez‐Ramos, L., & Duffy, D. (2011). Pregnancy outcomes in women with polycystic ovary syndrome: A metaanalysis. American Journal of Obstetrics & Gynecology, 204(6), 558.e1‐558.e6.•Li, N., Bi, X., Zhang, Y., Zhao, P., Zheng, T., & Dai M. (2011). Human papillomavirus infection and sporadic breast carcinoma risk: A meta‐analysis. Breast Cancer Research & Treatment, 126(2), 515‐520.•Lim, A,C., Hegeman, M.A., Huis In ‘T Veld, M.A., Opmeer, B.C., Bruinse, H.W., & Mol B.W. (2011). 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Meta‐analysis of randomized trials on the association of prophylactic acyclovir and HIV‐1 viral load in individuals coinfected with herpes simplex virus‐2. AIDS, 25(10), 1265‐1269.•Magee, L., Sawchuck, D., Synnes, A., & von Dadelszen, P. (2011). SOGC clinical practice guideline. Magnesium sulphate for fetal neuroprotection. Journal of Obstetrics & Gynaecology Canada, 33(5), 516‐529.•Martins, W.P., Rocha, I.A., Ferriani, R.A., & Nastri, C.O. (2011). Assisted hatching of human embryos: A systematic review and meta‐analysis of randomized controlled trials. Human Reproduction Update, 17(4), 438‐453.•Mastenbroek, S., Twisk, M., van der Veen, F., & Repping, S. (2011). Preimplantation genetic screening: A systematic review and meta‐analysis of RCTs. Human Reproduction Update, 17(4), 454‐466.•Medeiros, L.R., Duarte, C.S., Rosa, D.D., Edelweiss, M.I., Edelweiss, M., Silva, F.R.,…Rosa, M.I. (2011). 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