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This comprehensive text focuses on reasoning, critical thinking and pragmatic decision making in medicine. Based on the author’s extensive experience and filled with definitions, formulae, flowcharts and checklists, this fully revised second edition continues to provide invaluable guidance to the crucial role that clinical epidemiology plays in the expanding field of evidence-based medicine. Key Features: • Considers evidence-based medicine as a universal initiative common to all health sciences and professions, and all specialties within those disciplines • Demonstrates how effective practice is reliant on proper foundations, such as clinical and fundamental epidemiology, and biostatistics • Introduces the reader to basic epidemiological methods, meta-analysis and decision analysis • Shows that structured, modern, argumentative reasoning is required to build the best possible evidence and use it in practice and research • Outlines how to make the most appropriate decisions in clinical care, disease prevention and health promotion Presenting a range of topics seldom seen in a single resource, the innovative blend of informal logic and structured evidence-based reasoning makes this book invaluable for anyone seeking broad, in-depth and readable coverage of this complex and sometimes controversial field.
This textbook assembles the wealth of clinical experiences across multiple medical specialties and offers clinical pearls that will result in better patient care and are highly relevant to daily practice. This book has been compiled by many renowned clinicians, medical educators, and researchers who are experts in their respective disciplines across Australia, New Zealand and the United States. The chapters provide multiple cases in vignette format, illustrating the clinical pearls, and finish with a discussion and practical tips. This format will allow the reader to easily understand how the clinical pearls can be applied in clinical practice. Evidence-based medicine and clinical guidelines help us choose the best management and treatment options for our patients. However, many questions in medicine have not been researched or are not readily amenable to research. In fact, there is more to the art and mastery of practicing clinical medicine than the evidence-based approach. Information gained over years of reflective clinical practice and cumulative wisdom adds value to evidence-based clinical medicine. With experience and clinical gestalt playing an equal, if not a more prominent role than what evidence can offer in a physician’s approach to solving clinical problems, this book offers unique perspectives on the practice of medicine. Beyond Evidence-Based Medicine: Clinical Pearls from Experienced Physicians will be valuable for later-year medical students, medical educators, doctors in training, and consultant physicians alike. Aiming to improve the day-to-day medical practices of professionals, the Editors have invited experienced physicians to share their expertise culminating in a unique book with broad applicability and appeal.
Patient management is the central clinical task of medical care. Until the 1970s, there was no generally accepted method of ensuring a scientific, critical approach to clinical decision making. And while traditional clinical authority was under attack, there was increasing concern about the way in which doctors made decisions about patient care. In this book, Jeanne Daly traces the origins, essential features, and achievements of evidence-based medicine and clinical epidemiology over the past few decades. Drawing largely on interviews with key players, she offers unique insights into the ways that practitioners of evidence-based medicine set out to generate scientific knowledge about patient care and how, in the process, they reshaped the way medicine is practiced and administered.
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
A pioneer in the synthesis of science, holistic health, and contemporary spirituality, Dr. Patricia Muehsam introduces and explores a path to health and well-being that is extraordinary in its ease and profound in its results. This groundbreaking work explores what health and healing — physical, mental, emotional, and spiritual — really mean and offers a revolutionary new way to think about health. You’ll discover experiences of illness and healing that defy conventional thinking, explore the ancient wisdom and the modern science of consciousness, and learn practical tools for experiencing Absolute Health — which are also tools for navigating being human.
The most innovative leaders in progressive addiction treatment in the US offer a groundbreaking, science-based guide to helping loved ones overcome addiction problems and compulsive behaviors. The most innovative leaders in progressive addiction treatment in the US offer a groundbreaking, science-based guide to helping loved ones overcome addiction problems and compulsive behaviors. Beyond Addiction eschews the theatrics of interventions and tough love to show family and friends how they can use kindness, positive reinforcement, and motivational and behavioral strategies to help their loved ones change. Drawing on forty collective years of research and decades of clinical experience, the authors present the best practical advice science has to offer. Delivered with warmth, optimism, and humor, Beyond Addiction defines a new, empowered role for friends and family and a paradigm shift for the field. Learn how to tap the transformative power of relationships for positive change, guided by exercises and examples. Practice what really works in therapy and in everyday life, and discover many different treatment options along with tips for navigating the system. And have hope: this guide is designed not only to help someone change, but to help someone want to change.
Focusing on improving the diagnosis, prognosis, and management of human disease, this book takes on the issues of research design, measurement, and evaluation which are critical to clinical epidemiology. This second edition of Clinical Epidemiology: Practice and Methods opens with how best to frame a clinical research question, the ethics associated with doing a research project in humans, and the definition of various biases that occur in clinical research. From there, it continues by examining issues of design, measurement, and analysis associated with various research designs, including determination of risk in longitudinal studies, assessment of therapy in randomized controlled clinical trials, and evaluation of diagnostic tests, and then delves into the more specialized area of clinical genetic research, before concluding with basic methods used in evidence-based decision making including critical appraisal, aggregation of multiple studies using meta-analysis, health technology assessment, clinical practice guidelines, development of health policy, translational research, how to utilize administrative databases, and knowledge translation. Written for the highly successful Methods in Molecular Biology series, chapters include the kind of detail and practical advice to ensure real world success. Comprehensive and authoritative, Clinical Epidemiology: Practice and Methods, Second Edition is intended to educate researchers on how to undertake clinical research and should be helpful not only to medical practitioners but also to basic scientists who want to extend their work to humans, to allied health professionals interested in scientific evaluation, and to trainees in clinical epidemiology.
Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment.
The medical use of marijuana is surrounded by a cloud of social, political, and religious controversy, which obscures the facts that should be considered in the debate. This book summarizes what we know about marijuana from evidence-based medicineâ€"the harm it may do and the relief it may bring to patients. The book helps the reader understand not only what science has to say about medical marijuana but also the logic behind the scientific conclusions. Marijuana and Medicine addresses the science base and the therapeutic effects of marijuana use for medical conditions such as glaucoma and multiple sclerosis. It covers marijuana's mechanism of action, acute and chronic effects on health and behavior, potential adverse effects, efficacy of different delivery systems, analysis of the data about marijuana as a gateway drug, and the prospects for developing cannabinoid drugs. The book evaluates how well marijuana meets accepted standards for medicine and considers the conclusions of other blue-ribbon panels. Full of useful facts, this volume will be important to anyone interested in informed debate about the medical use of marijuana: advocates and opponents as well as policymakers, regulators, and health care providers.
This book explores the complex relationship between public health research and policy, employing tobacco control and health inequalities in the UK as contrasting case studies. It argues that focusing on research-informed ideas usefully draws attention to the centrality of values, politics and advocacy for public health debates.