Critical Appraisal of Epidemiological Studies and Clinical Trials

by Elwood, Mark

• ISBN13: 9780198529552
• ISBN10: 0198529554
• Edition: 3rd
• Format: Paperback
• Copyright: 2007-04-05
• Publisher: Oxford University Press

Summary

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 places in context by a summary of current developments.

Table of Contents

The importance of causal relationships in medicine and health care

Study designs which can demonstrate and test causation

The results obtained from studies of causation

Selection of subjects for study

Error and bias in observations

Confounding

Chance variation

Combining results from several studies: systematic review and meta-analysis

The diagnosis of causationCritical appraisal in action - introduction to Chapters 10 to 15

Critical appraisal of a randomized clinical trial

Critical appraisal of a randomized trial of a preventive agent

Critical appraisal of a prospective cohort study

Critical appraisal of a retrospective cohort study

Critical appraisal of a matched case-control study

Critical appraisal of a large, population based, case-control studyAnswers to self test questions

Methods of statistical analysis: formulae and worked examples

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