Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, Second Edition

by Guyatt, Gordon; Rennie, Drummond; Meade, Maureen; Cook, Deborah

• ISBN13: 9780071590341
• ISBN10: 007159034X
• Edition: 2nd
• Format: Paperback
• Copyright: 2008-05-21
• Publisher: McGraw-Hill Professional

Summary

The #1 guide to the principles and clinical applications of evidence-based medicine has just gotten better! No other resource helps you to put key evidence-based medicine protocols into daily clinical practice better than JAMA Users' Guides to the Medical Literature. An instant classic in its first edition, this detailed, yet highly readable reference demystifies the statistical, analytical, and clinical principles of evidence-based medicine, giving you a hands-on, practical resource that no other text can match. Here, you'll learn how to distinguish solid medical evidence from poor medical evidence, devise the best search strategies for each clinical question, critically appraise the medical literature, and optimally tailor evidence-based medicine for each patient. The new second edition of this landmark resource is now completely revised and refreshed throughout, with expanded coverage of both basic and advanced issues in using evidence-based medicine in clinical practice.

Author Biography

Gordon Guyatt, MD, Professor of Medicine, McMaster University, Hamilton, Ontario, Canada.

Drummond Rennie, MD, Deputy Editor, JAMA; Professor of Medicine, UCSF School of Medicine, San Francisco, CA

Maureen Meade, MD, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Deborah Cook, MD, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Table of Contents

Contributors	p. xi
Foreword	p. xvii
Preface	p. xxi
The Foundations
How to Use the Medical Literature-and This Book-to Improve Your Patient Care	p. 3
The Philosophy of Evidence-Based Medicine	p. 9
What Is the Question?	p. 17
Finding the Evidence	p. 29
Why Study Results Mislead: Bias and Random Error	p. 59
Therapy
Therapy (Randomized Trials)	p. 67
Does Treatment Lower Risk? Understanding the Results	p. 87
Confidence Intervals	p. 99
Advanced Topics in the Validity of Therapy Trials
An Illustration of Bias and Random Error	p. 109
Surprising Results of Randomized Trials	p. 113
Randomized Trials Stopped Early for Benefit	p. 153
The Principle of Intention to Treat	p. 167
N-of-1 Randomized Controlled Trials	p. 179
Clinical Decision Support Systems	p. 193
Advanced Topics in the Results of Therapy Trials
Hypothesis Testing	p. 209
Understanding the Results: More About Odds Ratios	p. 221
What Determines the Width of the Confidence Interval?	p. 231
Composite Endpoints	p. 237
Measuring Patients' Experience	p. 249
Advanced Topics in Applying the Results of Therapy Trials
Applying Results to Individual Patients	p. 273
Example Numbers Needed to Treat	p. 291
Dealing With Misleading Presentations of Clinical Trial Results	p. 301
Surrogate Outcomes	p. 317
Qualitative Research	p. 341
Harm (Observational Studies)
Harm (Observational Studies)	p. 363
Advanced Topics in Harm: Correlation and Regression	p. 383
Diagnosis
The Process of Diagnosis	p. 399
Differential Diagnosis	p. 407
Diagnostic Tests	p. 419
Advanced Topics in Diagnosis
Spectrum Bias	p. 439
Examples of Likelihood Ratios	p. 449
Measuring Agreement Beyond Chance	p. 481
Clinical Prediction Rules	p. 491
Prognosis
Prognosis	p. 509
Summarizing the Evidence
Summarizing the Evidence	p. 523
Advanced Topics in Systematic Reviews
Reporting Bias	p. 543
Fixed-Effects and Random-Effects Models	p. 555
Making Sense of Variability in Study Results	p. 563
When to Believe a Subgroup Analysis	p. 571
Moving From Evidence to Action
How to Use a Patient Management Recommendation	p. 597
Advanced Topics in Moving From Evidence to Action
Economic Analysis	p. 619
Decision Making and the Patient	p. 643
Moving From Evidence to Action: Recommendations About Screening	p. 663
Grading Recommendations	p. 679
Drug Class Effects	p. 703
Parallel but Separate Goals: Evidence-Based Practitioners and Evidence-Based Care	p. 717
Changing Behavior to Apply Best Evidence in Practice	p. 721
Teachers' Guides to the Users' Guides	p. 743
Glossary	p. 769
Index	p. 809
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