Odds Ratios Versus Relative Risk

Many great things have been written about the difference between Odds Ratios (OR) and Relative Risks (RR). Every medical student at some point has been taught the difference. Yet these statistical terms are confused and misused every day in both the writing of and the interpretation of literature (which we’ll talk more about at the end…

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Do The NHS Birth Recommendations Have Meaning for The US? Or, The Safety of Home Birth

Recently, The Guardian reported, in an article entitled Low-risk women urged to avoid hospital birth, on the British National Health Service (NHS) urging low-risk pregnant women to avoid hospital birth in favor of both attached and unattached birth centers and even midwife-led home birth. There are two questions that this recommendation raises: Is this the appropriate…

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The Illusion of Causality

Humans seek to explain and understand. We want answers and explanations. Our brains demand it. But our brains have developed many short-cuts to understanding and arriving at explanations. We call these biases. Many times our biases serve us well. Other times, they kill us. Bias is hard to overcome and it takes a lot of…

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Teaching Tool: The Stanford Medicine 25

Physical exam is struggling more and more to find its place in modern medicine. Numerous contemporary studies have shown limited or no diagnostic value of frequently utilized physical exam components, including breast and pelvic exams, but also many other general exams. There are at least three things occurring simultaneously that produce studies that show poor…

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Important Paper: The PORTO Study

I’m going to post links and summaries of important and influential papers periodically. These are papers which should change the way we practice or at least the way we think about certain aspects of OB/GYN or medicine in general. The current paper comes from the April, 2013 issue of The American Journal of Obstetrics and Gynecology and…

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What Should Be Done At The Postpartum Visit?

The postpartum or postnatal visit has evolved significantly over the decades. It remains a largely ill-defined, and poorly evidenced-based, episode of care. The value and content of the visit should be individualized to the patient. In 1966, G.W. Morley wrote an influential article entitled, The important “Ten B’s” of post-partum hospital care. As the name…

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