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This volume provides a selection of chapters on new developments in various areas of clinical medicine, including dental, surgery, and general practice. These scientific chapters analyze the diagnostic processes and inform of new and novel diagnostic techniques. This book is divided into two sections; the first section contains review papers and includes an overview of experimental and clinical medicine, explaining its history to modern times. The second section presents a selection of original research papers from respected authors on a variety of topics.
This volume, Advanced Studies in Experimental and Clinical Medicine: Modern Trends and Approaches, provides a selection of chapters on new developments in various areas of clinical medicine, including dental, surgery, and general practice.
Handbook of Sleep Research, Volume 30, provides a comprehensive review of the current status of the neuroscience of sleep research. It begins with an overview of the neural, hormonal and genetic mechanisms of sleep and wake regulation before outlining the various proposed functions of sleep and the role it plays in plasticity, and in learning and memory. Finally, the book discusses disorders of sleep and waking, covering both lifestyle factors that cause disrupted sleep and psychiatric and neurological conditions that contribute to disorders. - Emphasizes a comparative and multidisciplinary approach to the topic of sleep - Covers the neurobiology and physiology of sleep stages, mechanisms of waking, and dreaming - Discusses in detail the proposed functions of sleep, from health and rest, to memory consolidation and synaptic plasticity - Examines the current state of research in mammalian and non-mammalian species, ranging from primates to invertebrates
Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.
In this book, the author argues that no current philosophical theory of evidence in clinical medical science is adequate. None can accurately explain the way evidence is gathered and used to confirm hypotheses. To correct this, he proposes a new approach called the weight of evidence account. This innovative method supplies a satisfactory explanation and rationale for the “hierarchical pyramid” of evidence–based medicine, with randomized clinical trials and their derivatives, meta-analyses, and systematic reviews of randomized clinical trials at the top and case reports, case series, expert opinion, and the like at the bottom. The author illustrates the development of various “levels” of evidence by considering the evolution of less invasive surgical treatments for early breast cancer. He shows that the weight of evidence account explains the notion of levels of evidence and other efforts to rank them. In addition, he presents a defense of randomization as a method to maximize accuracy in the conduct of clinical trials. The title also considers ethical issues surrounding experimentation with medical therapies in human subjects. It illustrates and discusses these issues in studies of respiratory therapies in neonates and treatment for certain cancers in adults. The author shows that in many cases sufficient evidence can be accrued to warrant generally accepted new therapies without the need for evidence derived from randomized clinical trials.