Resources for evidence-based practice, July/August 2003 journal reviews.

This column highlights new resources that clarify knowledge about effects of specific practices in maternal/newborn and women's health. The focus is on new and recently updated systematic reviews and overviews of best research evidence. The column identifies recent additions to three major evidence-based databases: • Cochrane Database of Systematic Reviews (CDSR) uses a standardized method to review studies that evaluate effects of specific health care practices. It is a leading source of high-quality reviews. • Database of Abstracts of Reviews of Effects (DARE) is a compilation of structured abstracts of quality-assessed systematic reviews. Staff at the United Kingdom National Health Service's Centre for Reviews and Dissemination use quality criteria to determine whether a review is included and to develop abstracts. • Clinical Evidence is a source of overviews of the best available research about effects of interventions. These overviews from the BMJ Publishing Group generally examine multiple questions (for example, prevention and treatment) about specific health concerns. The column also identifies recent evidence-based research reviews from other sources and ends with a commentary. Skin patch and vaginal ring versus combined oral contraceptives for contraception. The objective of this review was to compare newer skin patch and vaginal ring contraceptives to oral contraceptives with respect to effects on contraceptive efficacy, cycle control, compliance, and safety. The reviewers included three relevant and methodologically adequate randomized controlled trials comparing skin patch and oral contraceptives but found no eligible trials evaluating the contraceptive vaginal ring. Patch and oral contraceptives did not differ with respect to contraceptive efficacy. In the two trials that examined discontinuation rates, one trial found no difference whereas another found more frequent discontinuation with the patch. Just one trial evaluated adverse effects, and breast discomfort was reported more frequently with the patch. This trial was too small to evaluate possible serious rare adverse effects. One trial measured self-reported compliance, which favored patch users. Comment: A small body of controlled trials has recently become available to explore possible advantages and drawbacks of the contraceptive skin patch relative to oral contraceptives. No comparable trials were identified for assessing the contraceptive vagi-nal ring. New • Cervical stitch (cerclage) for preventing pregnancy loss in women • Elective delivery of women with a twin pregnancy from 37 weeks' gestation • Interventions for treating placental abruption • Treatment for primary postpartum haemorrhage Updated • Calcium channel blockers for inhibiting preterm labour • Drugs for preventing malaria-related illness …