Obstetrics and gynecology
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Publication bias is the systematic, preferential publication of studies with statistically significant positive results over indeterminate studies (frequently, researchers inappropriately term these "negative" studies), or studies that show a statistically significant negative outcome. Over time, this practice distorts the medical literature, potentially compromising the validity of systematic reviews. Publication bias primarily stems from investigators, but data suppression can occur by pharmaceutical companies, universities, and regulatory agencies. ⋯ Prior attempts to encourage voluntary trial registration have been largely unsuccessful. Hence, the International Committee of Medical Journal Editors recently adopted a policy of mandatory clinical trial registration before consideration of manuscripts for publication. Trial registration and the development of comprehensive, computerized databases will promote transparency in research and help reduce publication bias.
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Obstetrics and gynecology · Jun 2007
ACOG committee opinion. Number 369. June 2007. Multifetal pregnancy reduction.
Counseling for treatment of infertility should include a discussion of the risks of multifetal pregnancy, multifetal pregnancy reduction should be discussed with patients before the initiations of any treatment that could increase the risk of multifetal pregnancy. In almost all cases, it is preferable to terminate an ovulation induction cycle or limit the number of embryos to be transferred to prevent a situation in which fetal reduction will have to be considered. The best interest of the patient and the future child or children should be at the center of the risk-benefit equation. Although no physicians need to perform fetal reductions if they believe that such procedures are morally unacceptable, all obstetricians and gynecologist should be aware of the medical and ethical issues in these complex situations and be prepared to respond in a professional, ethical manner.
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Obstetrics and gynecology · May 2007
Comparative StudyGender gaps in income and productivity of obstetricians and gynecologists.
To investigate differences in income, productivity, and practice style between male and female obstetrician-gynecologists between 1990 and 2002. ⋯ Between 1990 and 2002, female obstetrician-gynecologists earned lower annual incomes than male obstetrician-gynecologists, even when matched on age. However, by 2002 this income gap was almost entirely explained by gender differences in productivity and practice patterns.
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Obstetrics and gynecology · Apr 2007
Practice GuidelineACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists.
Preterm delivery occurs in approximately 12% of all births in the United States and is a major factor contributing to perinatal morbidity and mortality (1, 2). Despite extensive research in this area, the rate of preterm birth has increased by 38% since 1981 (3). Premature rupture of membranes (PROM) is a complication in approximately one third of preterm births. ⋯ Management hinges on knowledge of gestational age and evaluation of the relative risks of preterm birth versus intrauterine infection, abruptio placentae, and cord accident that could occur with expectant management. The purpose of this document is to review the current understanding of this condition and to provide management guidelines that have been validated by appropriately conducted outcome-based research. Additional guidelines on the basis of consensus and expert opinion also are presented.