Essential Evidence-Based Medicine

by Dan Mayer

• ISBN13: 9780521540278
• ISBN10: 0521540275
• Edition: CD
• Format: Multimedia
• Copyright: 2004-06-28
• Publisher: Cambridge University Press

Summary

Evidence Based Medicine (EBM), using the best evidence in the literature for the best care for an individual patient, sounds very simple. Yet, most medical students and physicians do not have the mathematical background or training to critically evaluate published research. This 'users guide' to EBM helps you become a more discriminating reader of the medical literature. An introduction to scientific methods and study design then leads on to a better understanding of measurements and sources of bias. There is a brief introduction to statistics and hypothesis testing (Type I and II errors) and measures of risk and efficacy. The second half of the book teaches medical decision-making including discussions of the clinical examination and sources of bias in that examination, likelihood ratios, sensitivity, specificity, and predictive values and advanced topics in medical decision making. This is an ideal introductory text for medical students and all health-care professionals.

Table of Contents

Preface

1. A brief history of medicine and statistics

2. What is evidence based?

3. Causation

4. The medical literature - an overview medicine

5. Searching the medical literature

6. Study design and strength of evidence

7. Instruments and measurements: precision and validity

8. Sources of bias

9. Review of basic statistics

10. Hypothesis testing

11. Type I errors and number needed to treat

12. Negative studies and type II errors

13. Risk assessment

14. Multivariate analysis

15. Randomized clinical trials (RCTs)

16. Scientific integrity and the responsible conduct of research

17. Applicability and strength of evidence

18. An overview of decision making in medicine

19. Sources of error in clinical decision making

20. The use of diagnostic tests

21. Diagnostic tests: likelihood ratios, sensitivity and specificity

22. Bayes' theorem, predictive values, post test probabilities and interval likelihood ratios

23. Comparing tests and using ROC curves

24. Incremental gain and the threshold approach to diagnostic testing

25. Sources of bias and critical appraisal of studies of diagnostic tests

26. Screening tests

27. Practice guidelines and clinical prediction rules

28. Decision analysis

29. Cost effective analysis

30. Outcome analysis

31. Meta-analysis

Appendix 1. Common medical journals

Appendix 2. Glossary

Appendix 3. Bibliography

Appendix 4. Levels of evidence and grades of recommendations

Appendix 5. Overview of critical appraisal

Appendix 6. Common statistical tests

Appendix 7. Useful Web sites

Appendix 8. Formulae

Appendix 9. Proof of Bayes' Theorem

Appendix 10. Balance sheet approach to calculating threshold values

Index.