The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed:
Hamilton EF, Smith S, Yang L, et al. Third- and fourth-degree perineal lacerations: defining high-risk clinical clusters. Am J Obstet Gynecol 2011;204:309.e1-6.
The full discussion appears at www.AJOG.org , pages e1-2 .
Discussion questions
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How would you classify this study design?
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What information do we have on the hospitals and the integrity of the database?
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How would you describe the analytic approach?
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What information is in the tables?
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What does the figure tell us?
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How might the information in this study be used?
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Do other methods exist for predicting outcomes?
In a new study, researchers used a novel statistical method to identify women who were most susceptible to 3rd- and 4th-degree perineal lacerations. First, they pinpointed independent risk factors. Then they determined which “toxic constellations” of risk factors most increased the likelihood of serious injury. While many existing studies examine individual risk factors, few group them, making this work especially noteworthy.
See related article, page 309
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