How to Read a Paper: Basics Ebm

by Greenhalgh

• ISBN13: 9780727911391
• ISBN10: 0727911392
• Format: Paperback
• Copyright: 1999-04-01
• Publisher: Blackwell Pub

Summary

This excellent book is a comprehensive introduction to the usefulness and potential applications of evidence based medicine in the clinical setting. Written for anyone, medically qualified or not, How to Read a Paper makes seemingly obscure concepts clear, using practical examples and considering all the main types of research paper.

Table of Contents

Foreword	xi
Professor Sir David Weatherall
Preface: Do you need to read this book?	xv
Acknowledgements	xvii
Why read papers at all?	1	(12)
Does ``evidence based medicine'' simply mean ``reading medical papers''?	1	(2)
Why do people often groan when you mention evidence based medicine?	3	(5)
Before you start: formulate the problem	8	(5)
Searching the literature	13	(21)
Reading medical articles	13	(1)
The Medline database	14	(20)
You are trying to find a particular paper that you know exists	15	(5)
You want to answer a very specific clinical question	20	(2)
You want to get general information quickly about a well defined topic	22	(3)
Your search gives you lots of irrelevant articles	25	(1)
Your search gives you no articles at all or not as many as you expected	26	(3)
You don't know where to start searching	29	(1)
Your attempt to limit a set leads to loss of important articles but does not exclude those of low methological quality	29	(1)
Medline hasn't helped, despite a through search	30	(4)
Getting your bearings (what is this paper about?)	34	(19)
The science of ``trashing'' papers	34	(2)
Three preliminary questions to get your bearings	36	(5)
Randomised controlled trials	41	(4)
Cohort studies	45	(1)
Case-control studies	46	(1)
Cross sectional surveys	47	(1)
Case reports	48	(1)
The traditional hierarchy of evidence	48	(1)
A note on ethical considerations	49	(4)
Assessing methodological quality	53	(16)
Was the study original?	53	(1)
Who is the study about?	54	(2)
Was the design of the study sensible?	56	(2)
Was systematic bias avoided or minimised?	58	(4)
Was assessment ``blind''?	62	(1)
Were preliminary statistical questions dealt with?	63	(3)
Summing up	66	(3)
Statics for the non-statistician	69	(18)
How can non-statisticians evaluate statistical tests?	69	(2)
Have the author set the scene correctly?	71	(5)
Paired data, tails, and outliers	76	(2)
Correlation, regression and causation	78	(2)
Probability and confidence	80	(3)
The bottom line (quantifying the risk of benefit and harm)	83	(2)
Summary	85	(2)
Papers that report drug trials	87	(10)
``Evidence'' and marketing	87	(2)
Making decisions about treatment	89	(1)
Surrogate end points	90	(4)
How to get evidence out of a ``drug rep''	94	(3)
Papers that report diagnostic or screening tests	97	(14)
Ten men in the dock	97	(1)
Validating diagnostic tests against a gold standard	98	(4)
Ten questions to ask about a paper that claims to validate a diagnostic or screening test	102	(6)
A note on likelihood ratios	108	(3)
Papers that summarise other papers (systematic reviews and meta-analyses)	111	(17)
When is a review systematic?	111	(3)
Evaluating systematic reviews	114	(5)
Meta-analysis for the non-statistician	119	(4)
Explaining heterogeneity	123	(5)
Papers that tell you what to do (guidelines)	128	(10)
The great guidelines debate	128	(2)
Do guidelines change clinicians' behaviour?	130	(2)
Questions to ask about a set of published guidelines	132	(6)
Papers that tell you what things cost (economic analyses)	138	(13)
What is economic analysis?	138	(2)
Measuring the costs and benefits of health interventions	140	(5)
Questions to ask about an economic analysis	145	(4)
Conclusion	149	(2)
Papers that go beyond numbers (qualitative research)	151	(12)
What is qualitative research?	151	(4)
Evaluating papers that describe qualitative research	155	(6)
Conclusion	161	(2)
Implementing evidence based findings	163	(14)
Surfactants v steroid: a case study in adopting evidence based practice	163	(3)
Changing the behaviour of health professiols	166	(3)
Introducing change in organisations	169	(2)
Implementing evidence based practice in health authorities and trusts	171	(1)
Priorities for further research on the implementation process	172	(5)
Appendix A: Checklists for finding, appraising, and implementing evidence	177	(10)
Appendix B: Evidence based quality filters for everyday use	187	(2)
Appendix C: Maximally sensitive search strings for research use (to be used mainly for research)	189	(2)
Appendix D: Assessing the effects of an intervention	191	(1)
Index	192