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Oregon Health Sciences University
Evidence-Based Decision Aids to Improve Women's Health
Grant Number: K08
5 years (2000-2005)
Project Description: The purpose of this research was
to develop an evidence-based childbirth decision support tool to weigh the
consequences for various childbirth methods, and test its effectiveness to
improve patients' shared-decisionmaking and satisfaction, and reduce feelings
of failure, anxiety and postpartum depression.
Career Goals: Dr. Guise is Associate Professor in the Department of Obstetrics and Gynecology at Oregon Health and Science University. She received her MD from the University of Washington and did her residency in Obstetrics and Gynecology at the University of North Carolina, Chapel Hill. This was followed by a Robert Wood Johnson Clinical Scholars appointment also at UNC, Chapel Hill where she earned her MPH. Dr. Guise then did a Primary Care Research Fellowship. She is an expert on translating research findings into practical tools for use by practitioners, patients, and policymakers.
Progress to Date: This grant has been
completed. The decision tool was tested in postpartum women who either had a VBAC or repeat cesarean. The two groups were similar in their risk preferences for harms to self or baby, although there was a trend for women choosing cesarean to be more risk averse particularly for infant outcomes. The two groups differed significantly in their preferences regarding non-health related considerations.
Highlights and Specific Accomplishments:
- AHRQ Study Section Reviewer.
- Ad hoc reviewer for several professional journals.
- HHS Office on Women's Health, National expert on breast-feeding, 2003.
- Media consultant for several national and local progams.
K-Generated Publications (selected):
JM, Hashima JN,
Osterweil P. Evidence-based VBAC. Best Practice and Research. Clinical
Obstetrics and Gynaecology 2005. 19(1):117-30.
McDonagh, MS, Osterweil, P Guise JM.
The benefits and risks of inducing labour in patients with prior Caesarean delivery:
A systematic evidence review. BJOG 2005. 112(8);1007-15.
Crowther CA, Huertas E, Guise JM, Horey D. Planned elective repeat caesarean
versus planned vaginal birth for women with a previous caesarean birth. Cochrane
Database of Systematic Reviews 2004. Issue 4.
Ghetti C, Chan B, Guise JM. Physicians' responses to patient requested Cesarean. Birth
Guise JM. Vaginal birth after Caesarean: Determining thresholds for risks requires
examining more than uterine rupture rates. British Medical Journal 2004.
Palda V, Guise JM, Wathen CM. Interventions to promote
breastfeeding: Applying the evidence in clinical practice. Canadian Medical
Association Journal 2004. 170(6):976-78.
DF, Berlin M, Guise JM. The relationship of health care delivery system
characteristics and legal factors to mode of delivery in women with prior
Cesarean section: A systematic review. Womens Health Issues 2004. 14(3):94-103.
JN, Eden KB, Nygren P, Osterweil P, Guise JM. Predicting vaginal birth after
Cesarean: a review of prognostic factors and screening tools. American Journal
of Obstetrics and Gynecology 2004. 190(2):547-55.
Guise JM, Berlin M, McDonough
M, Osterweil P, Nygren P, Helfand M. Safety
of vaginal birth after Cesarean: A systematic review. Obstetrics and
Gynecology 2004. 103(3):420-29.
Eden KB, Hashima JN, Osterweil P,
Nygren P, Guise JM. Childbirth preferences after Cesarean. Birth 2004.
JM, McDonagh M,
Osterweil P, et al. Systematic review of the incidence and consequences of uterine
rupture in women with prior Cesarean delivery. British Medical Journal 2004. 329(7456):9-23.
JM, Palada V,
Westhoff C, Lieu A. The effectiveness of primary care based interventions to promote
breastfeeding: Systematic evidence review and meta-analysis for the US
Preventive Services Task Force. Annals of Family Medicine 2003. 1(2):70-80.
MA, Guise JM, Carey JC. Treatment recommendations for bacterial vaginosis
in pregnant women [letter]. Clinical Infectious Disease 2003. 36:1630-31.
JM, McDonagh MS,
Hashima J, et al. Vaginal Birth after Cesarean. Evidence Report/Technology
Assessment No. 71. Rockville, MD. AHRQ. 2003.
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