Obstetric practice guidelines: labor's love lost?
Approach to Improving Safety
Setting of Care
Guidelines play an important role in enhancing safety and reliability, but they must be rigorously evidence-based, followed, and applied. This commentary suggests that overconfidence in the guideline development process can result in reliance on recommendations that misinform practice and contribute to patient harm. As an example, the authors discuss the wide adoption of a guideline to address the cesarean delivery rate that omitted important clinical prognosticators.