psyuk said:
Please read the following thread from another forum about SIDS.
http://www.igoo.com/Lounge/showthread.php?t=36608&page=1&pp=15
I'd appreciate any professional opinions you may have formed, especially with regards to the practice of evidence based medicine, which has been the focal point of the thread's discussion.
-Psyuk
are you asking for EBM with regards to SIDS? the last few years have seen a strong push for the Back To sleep campaign. some neonatal faculty actually think the research supporting this practice is less than superb, implicating other etiologies of SIDS than suffocation, but still stress that parents lay infants on their backs. there are quite a few interesting public health studies demonstrating that increased parental education reduces the risk of SIDS the most (not surprising), such as the following:
Widening social inequalities in risk for sudden infant death syndrome.
Pickett KE, Luo Y, Lauderdale DS.
Department of Health Sciences, Seebohm Rowntree Building, Area 3, University of York, Heslington, York, Y010 5DD, England.
[email protected].
OBJECTIVES: In 1994, the US Public Health Service launched the "Back to Sleep" campaign, promoting the supine sleep position to prevent sudden infant death syndrome (SIDS). Studies of SIDS in the United States have generally found socioeconomic and race disparities. Our objective was to see whether the "Back to Sleep" campaign, which involves an effective, easy, and free intervention, has reduced social class inequalities in SIDS. METHODS: We conducted a population-based case-cohort study during 2 periods, 1989 to 1991 and 1996 to 1998, using the US Linked Birth/Infant Death Data Sets. Case group was infants who died of SIDS in infancy (N = 21 126); control group was a 10% random sample of infants who lived through the first year and all infants who died of other causes (N=2241218). Social class was measured by mother's education level. RESULTS: There was no evidence that inequalities in SIDS were reduced after the Back to Sleep campaign. In fact, odds ratios for SIDS associated with lower social class increased between 1989-1991 and 1996-1998. The race disparity in SIDS increased after the Back to Sleep campaign. CONCLUSIONS: The introduction of an inexpensive, easy, public health intervention has not reduced social inequalities in SIDS; in fact, the gap has widened. Although the risk of SIDS has been reduced for all social class groups, women who are more educated have experienced the greatest decline.
PMID: 16254231 [PubMed - in process]
and here's one from the other side of the 'Back to Sleep' campaign:
ScientificWorldJournal. 2005 Jul 21;5:550-7.
A reassessment of the SIDS Back to Sleep Campaign.
Pelligra R, Doman G, Leisman G.
Ames Research Center, National Aeronautics and Space Administration, Moffett Field, CA 94035, USA.
[email protected]
The Back to Sleep Campaign was initiated in 1994 to implement the American Academy of Pediatrics' (AAP) recommendation that infants be placed in the nonprone sleeping position to reduce the risk of the Sudden Infant Death Syndrome (SIDS). This paper offers a challenge to the Back to Sleep Campaign (BTSC) from two perspectives: (1) the questionable validity of SIDS mortality and risk statistics, and (2) the BTSC as human experimentation rather than as confirmed preventive therapy. The principal argument that initiated the BTSC and that continues to justify its existence is the observed parallel declines in the number of infants placed in the prone sleeping position and the number of reported SIDS deaths. We are compelled to challenge both the implied causal relationship between these observations and the SIDS mortality statistics themselves.
http://www.thescientificworld.co.uk/headeradmin/upload/2005.03.71.pdf
PMID: 16075152 [PubMed - in process]
not sure if there is more you're looking for on this or not.
