Studying a Study and Testing a Test How to Read the Medical Evidence

by Riegelman, Richard K.

• ISBN13: 9780781745765
• ISBN10: 0781745764
• Edition: 5th
• Format: Paperback
• Copyright: 2004-10-25
• Publisher: LWW

Summary

In today's rapidly changing world of clinical practice, old assumptions quickly fall under the weight of new evidence. But to make effective clinical decisions, you must face a deluge of data published in the health research literature. With this best-selling text as your guide, you'll discover a concise, stepwise program that will help you evaluate clinical studies, identify flaws in study design, interpret statistics, and apply evidence from clinical research to your practice. Sharpen your analytical skills with these insightful features... . Step-by-step approach ideal for both students and practitioners guides you through the health research literature, showing you the ingredients that go into a meaningful study, clues to potential study flaws, and ways to apply solid evidence in clinical practice. . Uniform framework uses a simple six-point framework based on the mnemonic M.A.A.R.I.E. You will learn to evaluate studies in terms of Methods, Assignment, Assessment, Results, Interpretation, and Extrapolation. . Hypothetical illustrations demonstrate the limitations of today's published studies. . Unique learning aids--including question checklists, scenarios illustrating study design, and flaw-catching exercises--help you reinforce key facts and retain what you've learned. NEW to the Fifth Edition... . New "Guide to the Guidelines" section helps you make sense of established and emerging clinical guidelines, and helps you understand the role of these guidelines in practice. . Current information on outcomes includes discussions of safety and of the effects of interactions on outcomes. . More graphic presentation of statistics helps make complex concepts easy to grasp and apply using a flowchart of statistics. . StudyingaStudy.com Website is an integral feature of this edition providing interactive materials for all sections of the book. The Website provides practice using the M.A.A.R.I.E. framework, interactive flaw-catching and Selecting a Statistics exercises, self-testing questions-answers and exercises using abstracts from real articles. . Courses and Journal Clubs can now use Studying a Study and Testing a Test with the help of a special section of the Website.

Author Biography

Richard K. Riegelman, M.D., M.P.H., Ph.D.: Professor of Epidemiology-Biostatistics, Medicine, and Health Policy and Founding Dean, The George Washington University, School of Public Health and Health Services, Washington, D.C.

Table of Contents

Preface: Putting Progress Into Practice	v
Acknowledgments	vii
Introduction and Flaw-Catching Exercise	1	(6)
Section I. Studying a Study
Types of Studies and the M.A.A.R.I.E. Framework	7	(9)
Method	16	(4)
Assignment	20	(5)
Assessment	25	(7)
Results	32	(18)
Interpretation	50	(8)
Extrapolation	58	(9)
Randomized Clinical Trials	67	(22)
Database Research: Nonconcurrent Cohort Studies	89	(10)
Meta-analysis	99	(17)
Questions to Ask and Flaw-Catching Exercises	116	(21)
Section II. Testing a Test
Method	137	(6)
Assignment	143	(6)
Assessment	149	(8)
Results	157	(7)
Interpretation	164	(8)
Extrapolation	172	(3)
Screening	175	(9)
Questions to Ask and Flaw-Catching Exercises	184	(9)
Section III. Rating a Rate
Method and Assignment	193	(7)
Assessment	200	(4)
Results	204	(7)
Interpretation and Extrapolation	211	(9)
Life Expectancy	220	(7)
Questions to Ask and Flaw-Catching Exercises	227	(8)
Section IV. Considering Costs and Evaluating Effectiveness
Introduction and Method	235	(11)
Assignment	246	(5)
Assessment	251	(9)
Results	260	(9)
Interpretation	269	(7)
Extrapolation	276	(4)
Questions to Ask and Flaw-Catching Exercises	280	(13)
Section V. A Guide to the Guidelines
Method	293	(4)
Assignment	297	(3)
Assessment	300	(2)
Results	302	(6)
Interpretation	308	(9)
Extrapolation and Questions to Ask	317	(6)
Section VI. Selecting a Statistic
Basic Principles	323	(11)
Univariable Analysis	334	(7)
Bivariable Analysis	341	(9)
Multivariable Analysis	350	(12)
Selecting a Statistic Flowcharts	362	(7)
Glossary	369	(26)
Subject Index	395