| November 2006 · Vol. 18, No. 11 COMMENT & CONTROVERSY
Is “expert opinion” good enough for the patient?
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Fast Track
“In my experience, the vast majority of babies do not need any traction”
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“Shoulder dystocia: What is the legal standard of care?” by Henry M. Lerner, MD
I have 3 questions for Dr. Lerner. First, he cited a recommendation from the American College of Obstetricians and Gynecologists (ACOG) on the estimated fetal weight at which to offer cesarean delivery. That recommendation was graded by ACOG as level C: consensus or expert opinion. Should we inform our patients that our recommendation regarding cesare-an delivery for certain estimated fetal weights is based on opinion only, or even on level B evidence, defined as “limited or inconsistent scientific evidence”? According to a recent overview of practice bulletins,1 60% of the recommendations in the ACOG shoulder dystocia bulletin were level C, 40% were level B, and none were level A.
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