"Safe" and "effective" are defined as follows: Safety is the condition of presenting a reasonably low risk of harm, injury, or loss when a technology is utilized in the specified indication; and effectiveness is the quality of producing a desired, beneficial effect under the conditions of actual use. The categories for response to a DATTA question are defined as follows: Established—a technology demonstrated and accepted as safe and effective by the practicing medical community; investigational—a technology largely confined to use under research protocol; unacceptable—the risk/benefit ratio is unfavorable; and indeterminate—the evidence is insufficient for a definitive decision, and no consensus exists to date; further study may be warranted.
Preterm labor is defined as labor beginning between 20 and 36 completed weeks of gestation.
χ2 Analysis of the responses of the DATTA panelists determined that the frequencies (established, investigational, unacceptable, or indeterminate) differ significantly from those expected due to chance alone for questions A and B. Construction of the 95% confidence intervals comparing the established category vs the combination of investigational, unacceptable, and indeterminate showed a significant difference between these two groups for question B, indicating that the DATTA panelists believed the procedure had not been established as effective. Two DATTA panelists offered no opinion on questions A and B.
Health United States 1987 . Rockville, Md: US Dept of Health and Human Services; 1988;:48.
Vital Statistics of the United States: Natality . Rockville, Md: US Dept of Health, Education, and Welfare; 1977;;1:1-227.
Vital Statistics of the United States: Natality . Rockville, Md: US Dept of Health and Human Services; 1987;;1:255.
Lipshitz J, Brown RL. Preterm labor . In: Knuppel RA, Drukker JE, eds. High-Risk Pregnancy: A Team Approach . Philadelphia, Pa: WB Saunders Co; 1986;:303-324.
Committee to Study the Prevention of Low Birthweight, Institute of Medicine. Preventing Low Birthweight . Washington, DC: National Academy Press; 1985;:21-45.
Barden TP: Premature labor . In: Queenan JT, ed. Management of High Risk Pregnancy . 2nd ed. Oradell, NJ: Medical Economics Books; 1985;:535-544.
Gonik B, Creasy RK. Preterm labor: its diagnosis and management . Am J Obstet Gynecol. 1986;;154:3-8.
McGregor JA. Prevention of preterm birth: new initiatives based on microbial-host interactions . Obstet Gynecol Surv. 1988;;43:1-14.
Iams JD, Peaceman AM, Creasy RK. Prevention of prematurity . Sem Perinatol. 1988;;12:280-291.
Creasy RK, Gummer BA, Liggins GC. System for predicting spontaneous preterm birth . Obstet Gynecol. 1980;;55:692-695.
Main DM, Gabbe SG. Risk scoring for preterm labor: where do we go from here? Am J Obstet Gynecol. 1987;;157:789-793.
Nageotte MP, Dorchester W, Porto M, Keegan KA, Freeman RK. Quantitation of uterine activity preceding preterm, term and postterm labor . Am J Obstet Gynecol. 1988;;158:1254-1259.
Main DM, Katz M, Chiu G, Campion S, Gabbe SG. Intermittent weekly contraction monitoring to predict preterm labor in low-risk women: a blinded study . Obstet Gynecol. 1988;;72:757-760.
Herron MA, Katz M, Creasy RK. Evaluation of a preterm birth prevention program: preliminary report . Obstet Gynecol. 1982;;59:452-456.
Main DM, Gabbe SG, Richardson D, Strong S. Can preterm births be prevented? Am J Obstet Gynecol. 1985;;151:892-898.
Main DM, Richardson D, Gabbe SG, Strong S, Weller SC. Prospective evaluation of a risk scoring system for predicting preterm delivery in black inner city women . Obstet Gynecol. 1987;;69:61-66.
Newman RB, Gill PJ, Wittreich P, Katz M. Maternal perception of prelabor uterine activity . Obstet Gynecol. 1986;;68:765-769.
Brustman L, Anyaegbunam A, Belle C, Ingrasin J, Langer O. Uterine activity: perception vs electronic recording . In: Abstracts of the eighth annual meeting of the Society of Perinatal Obstetricians; February 3-6, 1988 ; Las Vegas, Nev. Abstract 67.
Katz M, Newman RB, Gill PJ. Assessment of uterine activity in ambulatory patients at high risk for preterm labor and delivery . Am J Obstet Gynecol. 1986;;154:44-47.
Katz M, Gill PJ. Initial evaluation of an ambulatory system for home monitoring and transmission of uterine activity data . Obstet Gynecol. 1985;;66:273-277.
Katz M, Gill PJ, Newman RB. Detection of preterm labor by ambulatory monitoring of uterine activity: a preliminary report . Obstet Gynecol. 1986;;68:773-778.
Morrison JC, Martin JN Jr, Martin RW, Gookin KS, Wiser WL. Prevention of preterm birth by ambulatory assessment of uterine activity: a randomized study . Am J Obstet Gynecol. 1987;;156:536-540.
Iams JD, Johnson FF, O'Shaughnessy RW, West LC. A prospective random trial of home uterine activity monitoring in pregnancies at increased risk of preterm labor . Am J Obstet Gynecol. 1987;;157:638-643.
Iams JD, Johnson FF, O'Shaughnessy RW. A prospective random trial of home uterine activity monitoring in pregnancies at increased risk of preterm labor: part II . Am J Obstet Gynecol. 1988;;159:595-603.
Dyson DC, Wellman E, Dyson J, Armstrong MA. The role of home uterine monitoring in the prevention of preterm birth in high risk patients . In: Abstracts of the eighth annual meeting of the Society of Perinatal Obstetricians; February 3-6, 1988 ; Las Vegas, Nev. Abstract 69.
Porto M, Nageotte MP, Hill D, Hill O, Keegan KA, Freeman RK. The role of home uterine activity monitoring in the prevention of preterm birth . In: Abstracts of the seventh annual meeting of the Society of Perinatal Obstetricians; February 6, 1987 ; Lake Buena Vista, Fla. Abstract 7.