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‘Clinical epidemiology’ is now widely promoted and taught as a ‘basic science’ of Evidence-Based Medicine, of clinical EBM to be specific. This book, however, is mostly about that which Miettinen takes to be the necessary substitute for this now-so-fashionable subject – namely, Theory of Clinical Medicine together with its subordinate Theory of Clinical Research. The leit motif in all of this is Miettinen’s perception of the need, and opportunity, to bring major improvements into clinical medicine in this Information Age, now that theoretical progress has made feasible the development of practice-guiding Expert Systems for it. Parts of this text constitute essential reading for whoever is expected, or otherwise inclined, to study – or teach – ‘clinical epidemiology,’ and the same is true of those who set policy for the education of future clinicians; but practically all of it is essential reading for future – and current – academics in the various disciplines of clinical medicine. After all, the text is the result of a concentrated effort, over a half-century no less, to really understand both clinical and community medicine and the research to advance the knowledge-base of these. Research epidemiologists, too, will find this text interesting and instructive.
Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.
The accompanying CD-ROM contains clinical examples, critical appraisals and background papers.
The book is organized so as to address in separate sections first the preparatory topics of medicine (clinical and epidemiological), science in general, and statistics (mathematical); then topics of epidemiological research proper; and, finally, topics of ‘meta-epidemiological’ clinical research. In those two main sections, a further grouping is based on the distraction between objects and methods of study. In this framework, the particular topics are addressed both descriptively and quasi-prescriptively, commonly with a number of explicatory annotations. This book is intended to serve as a handbook for whomever is, in whatever way, concerned with epidemiological or ‘meta-epidemiological’ clinical research. But besides this, it is also intended to serve as a textbook for students in introductory courses on ‘epidemiological’ research – to which end there is a suggested hierarchy of the concepts that might reasonably be covered.
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.
This updated edition of Painless Evidence-Based Medicine presents basic concepts and application of research statistics in simple and practical manner creating an introductory approach to the complex and technical subject of evidence-based medicine from experienced teachers. A simplified introductory approach to the complex and technical subject of evidence-based medicine from experienced teachers Approaches learning from the vantage point of clinical questions on therapy, diagnosis, prognosis or harm rather than the framework of study designs Provides tables and boxed case studies throughout highlighting key topics, or difficult issues, in an easy to read manner Emphasizes applicability of EBM, encouraging readers to dissect the evidence and how results can be applied to individual patients with different circumstances, varying values and preferences New to the Second Edition are chapters on health screening, clinical practice guidelines, and major updates incorporating recommended trial criteria
The “essential” companion to the landmark Users' Guides to the Medical Literature - completely revised and updated! 5 STAR DOODY'S REVIEW! "This second edition is even better than the original. Information is easier to find and the additional resources that will be available at www.JAMAevidence.com will provide readers with a one-stop source for evidence-based medicine."--Doody's Review Service Evidence-based medicine involves the careful interpretation of medical studies and its clinical application. And no resource helps you do it better-and faster-than Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice. This streamlined reference distills the most clinically-relevant coverage from the parent Users' Guide Manual into one highly-focused, portable resource. Praised for its clear explanations of detailed statistical and mathematical principles, The Essentials concisely covers all the basic concepts of evidence-based medicine--everything you need to deliver optimal patient care. It's a perfect at-a-glance source for busy clinicians and students, helping you distinguish between solid medical evidence and poor medical evidence, tailor evidence-based medicine for each patient, and much more. Now in its second edition, this carry-along quick reference is more clinically relevant--and more essential--than ever! FEATURES Completely revised and updated with all new coverage of the basic issues in evidence-based medicine in patient care Abundant real-world examples drawn from the medical literature are woven throughout, and include important related principles and pitfalls in using clinical research in patient care decisions Edited by over 60 internationally recognized editors and contributors from around the globe Also look for JAMAevidence.com, a new interactive database for the best practice of evidence based medicine.
Explains the mathematics involved in understanding and choosing an array of diagnostic and prognostic tests, in order to improve treatment.
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.
The Third Edition of this popular text focuses on clinical-practice research methods. It is written by clinicians with experience in generating and answering researchable questions about real-world clinical practice and health care—the prevention, treatment, diagnosis, prognosis, and causes of diseases, the measurement of quality of life, and the effects of innovations in health services. The book has a problem-oriented and protocol-based approach and is written at an introductory level, emphasizing key principles and their applications. A bound-in CD-ROM contains the full text of the book to help the reader locate needed information.