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Critical Appraisal of Medical Literature provides a step-by-step approach to help the reader reach a good level of proficiency in systematic critical appraisal of medical information. To this end, the book covers all the elements that are necessary to develop these skills and is a comprehensive guide to the subject. The book is written in three parts. The first part focuses on the logical justification and the validity of medical information. Its chapters present basic working definitions and discussions on relevant basic topics of statistics and epidemiology. The second part focuses on the complementary aspects of critique, common study designs and articles whose main topics are treatment, diagnosis, prognosis, aetiology, reviews, medical guidelines, audit, and qualitative research. The third part presents some statistical techniques that are commonly used in published articles. Critical Appraisal of Medical Literature is intended for those interested in developing critical appraisal skills such as psychiatric trainees preparing for the Critical Review Paper of the MRCPsych Examination in the UK, other practitioners as part of their preparation for examinations, and medical professionals and students as part of their introduction to aspects of systematic critical appraisal of medical information.
This handy pocket companion provides all the necessary guidance on how to understand medical research publications, read them critically and decide whether the content of those papers is clinically useful in the care of patients. Illustrated throughout with medically relevant examples, the accessible text encompasses all relevant aspects of study design and clinical audit to give a clear framework to support critical reading for the novice and more experienced reader.
Holistic approach to understanding medical statistics This hands-on guide is much more than a basic medical statistics introduction. It equips you with the statistical tools required for evidence-based clinical research. Each chapter provides a clear step-by-step guide to each statistical test with practical instructions on how to generate and interpret the numbers, and present the results as scientific tables or graphs. Showing you how to: analyse data with the help of data set examples (Click here to download datasets) select the correct statistics and report results for publication or presentation understand and critically appraise results reported in the literature Each statistical test is linked to the research question and the type of study design used. There are also checklists for critically appraising the literature and web links to useful internet sites. Clear and concise explanations, combined with plenty of examples and tabulated explanations are based on the authors’ popular medical statistics courses. Critical appraisal guidelines at the end of each chapter help the reader evaluate the statistical data in their particular contexts.
Offers a range of sample comparative journal extracts enabling Foundation Year doctors and MRCGP and MRCPsych candidates to practise their critical appraisal skills. This title includes extracts that cover the whole spectrum of critical appraisal, together with exercises for the reader to work through independently to improve their technique.
This book presents a logical system of critical appraisal, to allow readers to evaluate studies and to carry out their own studies more effectively. This system emphasizes the central importance of cause and effect relationships. Its great strength is that it is applicable to a wide range of issues, and both to intervention trials and observational studies. This system unifies the often different approaches used in epidemiology, health services research, clinical trials, and evidence-based medicine, starting from a logical consideration of cause and effect. The author's approach to the issues of study design, selection of subjects, bias, confounding, and the place of statistical methods has been praised for its clarity and interest. Systematic reviews, meta-analysis, and the applications of this logic to evidence-based medicine, knowledge-based health care, and health practice and policy are discussed. Current and often controversial examples are used, including screening for prostate cancer, publication bias in psychiatry, public health issues in developing countries, and conflicts between observational studies and randomized trials. Statistical issues are explained clearly without complex mathematics, and the most useful methods are summarized in the appendix. The final chapters give six applications of the critical appraisal of major studies: randomized trials of medical treatment and prevention, a prospective and a retrospective cohort study, a small matched case-control study, and a large case-control study. In these chapters, sections of the original papers are reproduced and the original studies placed in context by a summary of current developments.
The best-selling introduction to evidence-based medicine In a clear and engaging style, How to Read a Paper demystifies evidence-based medicine and explains how to critically appraise published research and also put the findings into practice. An ideal introduction to evidence-based medicine, How to Read a Paper explains what to look for in different types of papers and how best to evaluate the literature and then implement the findings in an evidence-based, patient-centred way. Helpful checklist summaries of the key points in each chapter provide a useful framework for applying the principles of evidence-based medicine in everyday practice. This fifth edition has been fully updated with new examples and references to reflect recent developments and current practice. It also includes two new chapters on applying evidence-based medicine with patients and on the common criticisms of evidence-based medicine and responses. How to Read a Paper is a standard text for medical and nursing schools as well as a friendly guide for everyone wanting to teach or learn the basics of evidence-based medicine.
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
This book addresses the most relevant aspects of radiation oncology in terms of technical integrity, dose parameters, machine and software specifications, as well as regulatory requirements. Radiation oncology is a unique field that combines physics and biology. As a result, it has not only a clinical aspect, but also a physics aspect and biology aspect, all three of which are inter-related and critical to optimal radiation treatment planning. In addition, radiation oncology involves a host of machines/software. One needs to have a firm command of these machines and their specifications to deliver comprehensive treatment. However, this information is not readily available, which poses serious challenges for students learning the planning aspect of radiation therapy. In response, this book compiles these relevant aspects in a single source. Radiation oncology is a dynamic field, and is continuously evolving. However, tracking down the latest findings is both difficult and time-consuming. Consequently, the book also comprehensively covers the most important trials. Offering an essential ready reference work, it represents a value asset for all radiation oncology practitioners, trainees and students.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.