Time for a relook at Spitzer's laws of neonatology?

Abstract

Thirty years ago, 20 tongue-in-cheek aphorisms relating to the practice of neonatology were published and became known as Spitzer’s laws of neonatology (SLN). They became widely cited, perhaps because they resonated with some of the experiences of practicing neonatologists at that time. The purpose of this study was to see if Spitzer’s laws still resonated with doctors currently practicing in neonatology. A questionnaire containing the 20 Spitzer’s laws was distributed to 17 pediatric doctors during their neonatology placement. Each statement has the options of it being noted as rubbish, funny, intuitively correct or evidence based. Respondents were allowed to give more than one opinion for each statement. Less than a quarter (23.5%, n=4) of 17 doctors had previously heard of Spitzer’s laws. Of the 355 opinions on Spitzer’s statements, almost half (42%) were said to be rubbish, less than a third (31%) were intuitively correct and one-fifth (21%) were said to be funny. Only 5% were thought to be evidence based. Statement 7 ‘The milder the RDS, the sooner the infant will find himself on 100% oxygen and maximal ventilatory support’, scored the highest as being the most rubbish statement (94%). It was also felt to be neither evidence based (0%), funny (0%) nor intuitively correct (6%). The aphorism,‘The month you are on service always has three times as many days as any other month on the calendar’, scored the highest (45%) as being the funniest. Statement 16, ‘If they ain’t breathin', they may be seizin'’ was considered the aphorism most likely to be evidence based (35%, n=7). A third (35%) of the doctors said they would use Spitzer’s laws for teaching future medical students. Many current neonatal practitioners still find SLN humorous but largely irrelevant and not evidence based.