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We welcome the interest and comments by Dr Sioulas et al1Sioulas V.D. Siristatidis C.S. Kassanos D. Evidence-based obstetrics and gynecology: still a marathon to run.Am J Obstet Gynecol. 2011; 204 (eX)Google Scholar concerning our recent publication. Dr Sioulas et al1Sioulas V.D. Siristatidis C.S. Kassanos D. Evidence-based obstetrics and gynecology: still a marathon to run.Am J Obstet Gynecol. 2011; 204 (eX)Google Scholar pose several questions about the quality of contemporary research in obstetrics and gynecology.In our paper, we characterized the 100 most frequently cited papers in obstetrics and gynecology journals during the last 50 years.2Brandt J.S. Downing A.C. Howard D.L. Kofinas J.D. Chasen S.T. Citation classics in obstetrics and gynecology: the 100 most frequently cited journal articles in the last 50 years.Am J Obstet Gynecol. 2010; 203: 355.e1-355.e7Abstract Full Text Full Text PDF PubMed Scopus (124) Google Scholar We demonstrated that the proportion of randomized controlled trials (RCTs) published before and after 1980 was similar. We restricted our review to journals of obstetrics and gynecology, excluding general medicine journals such as the New England Journal of Medicine. We acknowledge in our discussion that the exclusion of these journals may have “underestimated the reported impact of obstetrics and gynecology related RCTs.”Nevertheless, Dr Sioulas et al1Sioulas V.D. Siristatidis C.S. Kassanos D. Evidence-based obstetrics and gynecology: still a marathon to run.Am J Obstet Gynecol. 2011; 204 (eX)Google Scholar pose an important question about the quality of evidence that informs the clinical decision making of obstetrician-gynecologists. They ask: “are we still in lack of high quality evidence driving the fundamental aspects of our clinical practice?” Studies that have recently evaluated the quality of clinical trials in obstetrics and gynecology would suggest that post-1990s RCTs are better than earlier trials, but that there is still room for improvement. The recent update of CONSORT guidelines, which were revised this year, demonstrates that there still remains a long way to go.3Grimes D.A. The CONSORT guidelines: sound advice, spotting compliance.Obstet Gynecol. 2010; 115: 892-893Crossref PubMed Scopus (3) Google ScholarWe agree with Dr Sioulas that RCTs remain the best tool to judge the effectiveness of medical interventions and to inform (and not replace) common sense and sound clinical judgment. We are happy that our paper may draw some attention to these issues. We welcome the interest and comments by Dr Sioulas et al1Sioulas V.D. Siristatidis C.S. Kassanos D. Evidence-based obstetrics and gynecology: still a marathon to run.Am J Obstet Gynecol. 2011; 204 (eX)Google Scholar concerning our recent publication. Dr Sioulas et al1Sioulas V.D. Siristatidis C.S. Kassanos D. Evidence-based obstetrics and gynecology: still a marathon to run.Am J Obstet Gynecol. 2011; 204 (eX)Google Scholar pose several questions about the quality of contemporary research in obstetrics and gynecology. In our paper, we characterized the 100 most frequently cited papers in obstetrics and gynecology journals during the last 50 years.2Brandt J.S. Downing A.C. Howard D.L. Kofinas J.D. Chasen S.T. Citation classics in obstetrics and gynecology: the 100 most frequently cited journal articles in the last 50 years.Am J Obstet Gynecol. 2010; 203: 355.e1-355.e7Abstract Full Text Full Text PDF PubMed Scopus (124) Google Scholar We demonstrated that the proportion of randomized controlled trials (RCTs) published before and after 1980 was similar. We restricted our review to journals of obstetrics and gynecology, excluding general medicine journals such as the New England Journal of Medicine. We acknowledge in our discussion that the exclusion of these journals may have “underestimated the reported impact of obstetrics and gynecology related RCTs.” Nevertheless, Dr Sioulas et al1Sioulas V.D. Siristatidis C.S. Kassanos D. Evidence-based obstetrics and gynecology: still a marathon to run.Am J Obstet Gynecol. 2011; 204 (eX)Google Scholar pose an important question about the quality of evidence that informs the clinical decision making of obstetrician-gynecologists. They ask: “are we still in lack of high quality evidence driving the fundamental aspects of our clinical practice?” Studies that have recently evaluated the quality of clinical trials in obstetrics and gynecology would suggest that post-1990s RCTs are better than earlier trials, but that there is still room for improvement. The recent update of CONSORT guidelines, which were revised this year, demonstrates that there still remains a long way to go.3Grimes D.A. The CONSORT guidelines: sound advice, spotting compliance.Obstet Gynecol. 2010; 115: 892-893Crossref PubMed Scopus (3) Google Scholar We agree with Dr Sioulas that RCTs remain the best tool to judge the effectiveness of medical interventions and to inform (and not replace) common sense and sound clinical judgment. We are happy that our paper may draw some attention to these issues. Evidence-based obstetrics and gynecology: still a marathon to runAmerican Journal of Obstetrics & GynecologyVol. 205Issue 1PreviewWe read with great interest the article by Brandt et al on the 100 most frequently cited papers in obstetrics and gynecology journals during the last 50 years.1 Surprisingly, only 7 RCTs were included, whereas the rational increase in influential RCTs percentage after 1980 was rather disappointing. As the authors admit, the exclusion of articles published in general medicine and surgery journals may have underestimated the reported impact of obstetrics and gynecology related RCTs. Moreover, the poor quality of the reporting RCTs conducted before mid 1990s may have undermined their use as references. Full-Text PDF