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Table 5 What this study adds

From: Evidence-informed obstetric practice during normal birth in China: trends and influences in four hospitals

What is already known on this subject
A gap between evidence and practice in managing normal labour is common in many countries.
Practice change is often influenced by opinion leaders.
What this study adds
In some hospitals in Shanghai there is a substantive gap between best practice derived from reliable evidence and actual practice.
Over four years (1999–2003), obstetric practice in these hospitals became more evidence-informed, with substantive changes in some routine procedures.
Change towards evidence-informed practice was mainly influenced by the hospital director; change away from evidence-based practice was the result of legislation about medical accidents.
Regional seminars about best practice seemed to have had little direct influence on change.