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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 focuses on performing hands-on meta-analysis using MetaXL, a free add-on to MS Excel. The illustrative examples are taken mainly from medical and health sciences studies, but the generic methods can be used to perform meta-analysis on data from any other discipline. The book adopts a step-by-step approach to perform meta-analyses and interpret the results. Stata codes for meta-analyses are also provided. All popularly used meta-analytic methods and models – such as the fixed effect model, random effects model, inverse variance heterogeneity model, and quality effect model – are used to find the confidence interval for the effect size measure of independent primary studies and the pooled study. In addition to the commonly used meta-analytic methods for various effect size measures, the book includes special topics such as meta-regression, dose-response meta-analysis, and publication bias. The main attraction for readers is the book’s simplicity and straightforwardness in conducting actual meta-analysis using MetaXL. Researchers would easily find everything on meta-analysis of any particular effect size in one specific chapter once they could determine the underlying effect measure. Readers will be able to see the results under different models and also will be able to select the correct model to obtain accurate results.
The second edition of this best-selling book has been thoroughly revised and expanded to reflect the significant changes and advances made in systematic reviewing. New features include discussion on the rationale, meta-analyses of prognostic and diagnostic studies and software, and the use of systematic reviews in practice.
Analyses the data in health sciences and policy by introducing meta-analysis strategies while reviewing commonly used techniques. This text provides various chapters that build on principles, develop methodologies to solve statistical problems, and present concrete applications used by experienced medical practitioners and health policymakers.
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Major text including chapters on the following: defining outcome measures; assessing heterogeneity; using fixed effects methods and random effects models for combining study estimates; publication bias.
This remarkable text raises the analysis of data in health sciences and policy to new heights of refinement and applicability by introducing cutting-edge meta-analysis strategies while reviewing more commonly used techniques. Each chapter builds on sound principles, develops methodologies to solve statistical problems, and presents concrete applications used by experienced medical practitioners and health policymakers. Written by more than 30 celebrated international experts, Meta-Analysis in Medicine and Health Policy employs copious examples and pictorial presentations to teach and reinforce biostatistical techniques more effectively and poses numerous open questions of medical and health policy research.
In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.
Over the last twenty years there has been a dramatic upsurge in the application of meta-analysis to medical research. This has mainly been due to greater emphasis on evidence-based medicine and the need for reliable summaries of the vast and expanding volume of clinical research. At the same time there have been great strides in the development and refinement of the associated statistical methodology. This book describes the planning, conduct and reporting of a meta-analysis as applied to a series of randomized controlled clinical trials. * The various approaches are presented within a general unified framework. * Meta-analysis techniques are described in detail, from their theoretical development through to practical implementation. * Each topic discussed is supported by detailed worked examples. * A comparison of fixed and random effects approaches is included, as well as a discussion of Bayesian methods and cumulative meta-analysis. * Fully documented programs using standard statistical procedures in SAS are available on the Web. Ideally suited for practising statisticians and statistically-minded medical professionals, the book will also be of use to graduate students of medical statistics. The book is a self-contained and comprehensive account of the subject and an essential purchase for anyone involved in clinical trials.
Systematic Reviews in Health Research Explore the cutting-edge of systematic reviews in healthcare In this Third Edition of the classic Systematic Reviews textbook, now titled Systematic Reviews in Health Research, a team of distinguished researchers deliver a comprehensive and authoritative guide to the rapidly evolving area of systematic reviews and meta-analysis. The book demonstrates why systematic reviews—when conducted properly—provide the highest quality evidence on clinical and public health interventions and shows how they contribute to inference in many other contexts. The new edition reflects the broad role of systematic reviews, including: Twelve new chapters, covering additional study designs, methods and software, for example, on genetic association studies, prediction models, prevalence studies, network and dose-response meta-analysis Thorough update of 15 chapters focusing on systematic reviews of interventions Access to a companion website offering supplementary materials and practical exercises (www.systematic-reviews3.org) A key text for health researchers, Systematic Reviews in Health Research is also an indispensable resource for practitioners, students, and instructors in the health sciences needing to understand research synthesis.