Up From Clinical Epidemiology Ebm

‘Clinical epidemiology’ is now widely promoted and taught as a ‘basic science’ of Evidence-Based Medicine, of clinical EBM to be specific. This book, however, is mostly about that which Miettinen takes to be the necessary substitute for this now-so-fashionable subject – namely, Theory of Clinical Medicine together with its subordinate Theory of Clinical Research. The leit motif in all of this is Miettinen’s perception of the need, and opportunity, to bring major improvements into clinical medicine in this Information Age, now that theoretical progress has made feasible the development of practice-guiding Expert Systems for it. Parts of this text constitute essential reading for whoever is expected, or otherwise inclined, to study – or teach – ‘clinical epidemiology,’ and the same is true of those who set policy for the education of future clinicians; but practically all of it is essential reading for future – and current – academics in the various disciplines of clinical medicine. After all, the text is the result of a concentrated effort, over a half-century no less, to really understand both clinical and community medicine and the research to advance the knowledge-base of these. Research epidemiologists, too, will find this text interesting and instructive.

Having last year published “Up from Clinical Epidemiology & EBM” and also “Epidemiological Research: Terms and Concepts,” Miettinen now – this time with collaboration from his junior colleague I. Karp – brings out this further introduction into epidemiological research; and he is now working on an introduction into clinical research, for publication next year. It evidently is Miettinen’s felt time to crystallize the basic understandings he has come to as the culmination of a half-century of concentrated effort to advance the theory of epidemiological and ‘meta-epidemiological clinical’ research. In accord with its title, this book focuses on research to develop the knowledge-base for preventive medicine, which mainly is knowledge about the causal origin –etilogy, etiogenesis – of illness. It first illustrates how wanting this knowledge still is, despite much research; and it then aims to guide the reader to more productive etiogenetic research. This book places much emphasis on the need to assure relevance by principles-guided objects design for the studies, which now remains conspicuously absent from epidemiologists’ concerns. And as for methods design, this book exposes the fallacies in the still-common ‘cohort’ and ‘case-control’ studies, defines the essentials of all etiogenetic studies, and then addresses the true options for design in this framework of shared essentials. A good deal of attention is also given to the still commonly-held, very major, twin fallacies that screening for an illness is a preventive intervention, to be studied by randomized trials, and that research on it can imply rational guidelines or recommendations regarding decisions about the screening. While Miettinen already is regarded as ‘the father of modern epidemiology,’ he now appears to have become the father also of post-modern epidemiology, where ‘epidemiology’ still means epidemiological research.

This comprehensive text focuses on reasoning, critical thinking and pragmatic decision making in medicine. Based on the author's extensive experience and filled with definitions, formulae, flowcharts and checklists, this fully revised second edition continues to provide invaluable guidance to the crucial role that clinical epidemiology plays in the expanding field of evidence-based medicine. Key Features: - Considers evidence-based medicine as a universal initiative common to all health sciences and professions, and all specialties within those disciplines - Demonstrates how effective practice is reliant on proper foundations, such as clinical and fundamental epidemiology, and biostatistics - Introduces the reader to basic epidemiological methods, meta-analysis and decision analysis - Shows that structured, modern, argumentative reasoning is required to build the best possible evidence and use it in practice and research - Outlines how to make the most appropriate decisions in clinical care, disease prevention and health promotion Presenting a range of topics seldom seen in a single resource, the innovative blend of informal logic and structured evidence-based reasoning makes this book invaluable for anyone seeking broad, in-depth and readable coverage of this complex and sometimes controversial field.

Patient management is the central clinical task of medical care. Until the 1970s, there was no generally accepted method of ensuring a scientific, critical approach to clinical decision making. And while traditional clinical authority was under attack, there was increasing concern about the way in which doctors made decisions about patient care. In this book, Jeanne Daly traces the origins, essential features, and achievements of evidence-based medicine and clinical epidemiology over the past few decades. Drawing largely on interviews with key players, she offers unique insights into the ways that practitioners of evidence-based medicine set out to generate scientific knowledge about patient care and how, in the process, they reshaped the way medicine is practiced and administered.

Evidence-Based Diagnosis explains diagnostic, screening, and prognostic tests in clinical medicine. The authors' approach is based on many years of experience teaching physicians in a clinical research training program. Although needing only a minimum of mathematics, the quantitative discussions in this book are deeper and more rigorous than in most introductory texts. The book includes numerous worked examples and 60 problems (with answers) based on real clinical situations and journal articles. This book is a great choice for anyone looking to select, develop, or apply medical tests. Topics covered include: the diagnostic process; test reliability and accuracy; testing and treatment thresholds; critical appraisal of studies of diagnostic, screening and prognostic tests; test independence and methods of combining tests; quantifying treatment benefits using randomized trials and observational studies; Bayesian interpretation of P values and confidence intervals; challenges for evidence-based diagnosis; likelihood ratios and ROC curves.

The accompanying CD-ROM contains clinical examples, critical appraisals and background papers.

The Third Edition of this popular text focuses on clinical-practice research methods. It is written by clinicians with experience in generating and answering researchable questions about real-world clinical practice and health care—the prevention, treatment, diagnosis, prognosis, and causes of diseases, the measurement of quality of life, and the effects of innovations in health services. The book has a problem-oriented and protocol-based approach and is written at an introductory level, emphasizing key principles and their applications. A bound-in CD-ROM contains the full text of the book to help the reader locate needed information.

Translating the evidence from the bedside topopulations This sixth edition of the best-selling Epidemiology,Evidence-based Medicine and Public Health Lecture Notes equipsstudents and health professionals with the basic tools required tolearn, practice and teach epidemiology and health prevention in acontemporary setting. The first section, ‘Epidemiology’, introduces thefundamental principles and scientific basis behind work to improvethe health of populations, including a new chapter on geneticepidemiology. Applying the current and best scientific evidence totreatment at both individual and population level is intrinsicallylinked to epidemiology and public health, and has been introducedin a brand new second section: ‘Evidence-basedMedicine’ (EBM), with advice on how to incorporate EBMprinciples into your own practice. The third section, 'PublicHealth', introduces students to public health practice, includingstrategies and tools used to prevent disease, prolong life, reduceinequalities, and includes global health. Thoroughly updated throughout, including new studies and casesfrom around the globe, key learning features include: Learning objectives and key points in every chapter Extended coverage of critical appraisal and datainterpretation A brand new self-assessment section of SAQs and’True/False’ questions for each topic A glossary to quickly identify the meaning of key terms, all ofwhich are highlighted for study and exam preparation Further reading suggestions on each topic Whether approaching these topics for the first time, starting aspecial study module or placement, or looking for a quick-referencesummary, this book offers medical students, junior doctors, andpublic health students an invaluable collection of theoretical andpractical information.