Originally Posted by wannabe  ... Maybe there is some specific reason why intention to treat is a bigger problem with breech than other interventions/circumstances being studied. ... |
Maybe it's not the way the data is treater per se that is the problem, but rather the way the results iof the trial have been jumped on by the obstetric brigade. We need to remember than evidence based practice is the 'judicious and appropriate' application of research evidence to practice. In this case, the conclusion of the TBT has been interpreted as 'the outcomes show that CS is safer than vaginal delivery' rather than it being interpreted as 'the intention for CS' being compared with the 'intention for vaginal delivery' I know that you could say that this is just semantics, but the two things mean entirely different things.
There seems to be a tendency to misapply research to practice, without considering whether both the robustness of the research, and whether it is a valid application (look at all the research inappropriately applied to found the active management of labour movement..)