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Re: Ovarian hyperstimulation syndrome (OHSS)

industry. 3. When reviewing evidence, it is important to be sure that what we view as reinforcing our beliefs is not simply confirmation bias. The Hannah example is interesting because the reaction of the academic community to those data seemed to work to remove the woman’s choice for vaginal breech birth but we would question whether that was in the best interest of women? It could be that if service users had been involved in the interpretation of the results, that a wide range of opinions might have become evident. Academic judgments can also be at odds with clinicians in practice. After a debate at the RCOG in 2002, just one member of the audience of 200 clinicians put their hand up to support the conclusions of the Hannah breech trial. Perhaps, we need to consider more sophisticated means of synthesising evidence into guidance? 4. Yes, we do see a difference between research evidence and best practice for the patient though we might phrase it slightly differently. Good research provides information that helps define interventions that can be offered to women, but we need to be cautious as to who makes that interpretation, ensuring that service users are involved. We also hold that whilst healthcare workers are bound by the spirit of co-created guidance, those seeking healthcare are not. When advising an individual woman, we need to use our expertise to take account of her individual circumstance, but we must also use our wisdom to allow her the freedom to line up her needs, wishes and beliefs alongside the guidance for herself. Put another way, national recommendations guide a doctor or midwife on how to advise a woman, but they do not tell the woman what to do. Put in a slightly heartless way – clinicians advise, patients decide. It might be that an individual woman does view a 1 in 300 risk to her singleton term breech baby as being high, but then again, she might not.