2.4 Assessing reports

Home-birthing has many supporters and detractors. But how safe is home-birthing? Consider the newspaper report shown in Fig. 2.1, based on a research article (Murphy and Fullerton 1998). Answer the questions that follow.

FIGURE 2.1: From: The Toowoomba Chronicle, 22 February 1999

Identify the outcome and response variable.
Identify the comparison and explanatory variable.
Explain whether the study is observational or experimental.
Which of the following are likely to be extraneous variables, or confounding variables, or neither? Explain.
1. The maximum temperature on the day of giving birth.
2. The health of the mother.
3. The distance to the nearest hospital.
4. The number of previous births by the mother.
5. The gender of the baby.
If the study is experimental, determine if the principles of randomization, control, blinding and double-blinding, and blocking have been used. Also, determine if it is a quasi-experiment or a true experiment.
If the study is observational, determine if the study uses a forward direction (cohort study), a backward direction (case-control study), or is non-directional (cross sectional).
Suggest the RQ asked at the start of the study by identifying POCI.
Is a cause-and-effect relationship reasonable? Explain.
Read the extract from the original article below (Murphy and Fullerton 1998). What is the sampling method? Why are these limitations? What other limitations of the study can you think of?

There are several limitations to note in this report. The results reported here reflect a sample of nurse--midwifery practices willing to participate in data collection and to permit the resulting scrutiny of their practices. We cannot draw comparisons to non-participating nurse--midwifery practices or to the home birth practices of physician and other midwife providers.

--- Murphy and Fullerton (1998)

Based on this report, do you or do you not agree that (in general) a home birth is safer than a hospital birth? Explain.
Is the article headline consistent with the study conclusions?

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References

Murphy PA, Fullerton J. Outcomes of intended home births in nurse-midwifery practice: A prospective descriptive study. Obstetrics and Gynecology. 1998;92(3):461–70.