1. Journal Club Notes

2. Outcomes of Term Induction in Trial of Labor After Cesarean Delivery

3. Primary Outcomes Most important Most clinically significant
Easiest to measure
Sample size is usually based on primary outcomes
Choose 1 to 2 primary outcomes

4. Secondary outcomes Other outcomes of interest
Clinical, patient satisfaction, economic
Unintended or unexpected side effects
Adverse events

5. Composite outcomes Used for adverse but rare events
Increases statistical power for rare events
Power is the ability of the study to detect a true difference
If a study is underpowered, then there may be a true difference but the study cannot detect it – result is not statistically
TOLAC study used composite maternal morbidity and composite neonatal morbidity to increase power

6. Outcomes of Term Induction in TOLAC
Study was underpowered to detect differences in individual maternal morbidities by weeks of gestation
Severe maternal morbidity and uterine rupture are rare events
Results may be statistically insignificant because there are too few cases in the sample
Review Table 4
E.g. 37 weeks gestation OR 4.22; 95% CI ( )