Junk Science or an Inconvenient Truth?

In a recent article published in the Green Journal, ACOG's monthly academic publication, and much their credit, it was revealed that many guidelines used as "gospel" to counsel patients on OB/Gyn matters are not based on good science. In an article by Christie Haskell on the CafeMom web site she notes the following:

According to Professor of Medicine, Dr. Andrew D. Auerbach, "more than two thirds" of recommendations are based on anecdotal evidence or even just expert opinions, which are wrought with personal biases. While opinion can be helpful where we don't know things, it doesn't always translate into what's best for the patients.

In the new study, Dr. Jason D. Wright of Columbia University in New York and colleagues went through 717 practice recommendations from ACOG, the nation's leading group of ob-gyns.

They found 30 percent of those were based on top-notch evidence, so-called randomized controlled trials. About 38 percent came from observational studies, whose value is limited, and 32 percent were purely expert opinion.


Awareness of this information is crucial in the informed consent process. Asking questions of your doctor about the veracity of the evidence for his/her recommmendation is a good idea and should be greeted with respect by your practitioner. Remember, ACOG guidelines are meant to be just that, guidelines, and yet once published they become the basis for strict hospital policies and fodder for trial lawyers. Again, I give credit to the editors and the author for pubishing this article. Hopefully, it is based on good scientific method. Dr F