The ongoing quandary of defining the standard of care for neonates.

UNLABELLED: Despite extensive use of the term 'standard of care' (SOC), there is no such medical definition. How are neonatal therapies accepted as SOC with huge centre-to-centre variation? What defines SOC? We will consider paths to acceptance of multiple therapies (antenatal corticosteroids, preventing GBS, others). We conclude single-centre trials drive care, but are not consistently predictive for multicentre trials. Innovation/quality improvement initiatives also alter care, despite strong evidence practice changes take time. Furthermore, there are powerful medico-legal implications if a therapy is designated SOC.

CONCLUSION

Defining SOC is a quandary with more legal implications than medical, but what's most critical is keeping current in a rapidly changing field.