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內容簡介: |
How to Read a Paper describes the different types of clinical
research reporting, and explains how to critically appraise the
publications. The book provides the tools to find and evaluate the
literature, and implement the findings in an evidence-based,
patient-centered way. Written for anyone in the health care
professions who has little or no knowledge of evidence-based
medicine, it provides a clear understanding of the concepts and how
to put them into practice at the basic, clinical level.
Changes for the 4th edition
The fourth edition will include two new chapters on developments
in health care research and delivery, but otherwise retains its
original style, size, and scope. New chapter on quality improvement
– describing papers on quality improvement projects using ebm
methods; this will extend the readership to non clinical health
care professionals working in hospitals and family practice, and to
nurse spets and practice nurses working in this field New chapter
on complex interventions - how to set up research projects
involving both qualitative and quantitative methodology known as
mixed methods Thorough revision and updating of existing chapters
and references New illustrations – diagrammatic representations of
ebm concepts
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目錄:
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Foreword to the First Edition by Professor Sir David
Weatherall.
Preface to the First Edition: do you need to read this book?
Preface to the Fourth Edition.
Acknowledgements.
1 Why read papers at all?
1.1 Does ''evidence-based medicine'' simply mean ''reading papers in
medical journals''?
1.2 Why do people sometimes groan when you mention EBM?
1.3 Before you start: formulate the problem.
2 Searching the literature.
2.1 What are you looking for?
2.2 Levels upon levels of evidence.
2.3 Synthesised sources: systems, summaries and syntheses.
2.4 Pre-appraised sources: synopses of systematic reviews and
primary studies.
2.5 Speed resources.
2.6 Primary studies – tackling the jungle.
2.7 One-stop shopping: federated search engines.
2.8 Asking for help and asking around.
3 Getting your bearings – what is this paper about?
3.1 The science of ''trashing'' papers.
3.2 Three preliminary questions to get your bearings.
3.3 Randomised controlled trials.
3.4 Cohort studies.
3.5 Case-control studies.
3.6 Cross-sectional surveys.
3.7 Case reports.
3.8 The traditional hierarchy of evidence.
3.9 A note on ethical considerations.
4 Assessing methodological quality.
4.1 Was the study original?
4.2 Whom is the study about?
4.3 Was the design of the study sensible?
4.4 Was systematic bias avoided or minimised?
4.5 Was assessment ''blind''?
4.6 Were preliminary statistical questions addressed?
4.7 Summing up.
5 Statistics for the non-statistician.
5.1 How can non-statisticians evaluate statistical tests?
5.2 Have the authors set the scene correctly?
5.3 Paired data, tails, and outliers.
5.4 Correlation, regression and causation.
5.5 Probability and confidence.
5.6 The bottom line.
5.7 Summary.
6 Papers that report trials of drug treatments and other simple
interventions.
6.1 ‘Evidence’ and marketing.
6.2 Making decisions about therapy.
6.3 Surrogate endpoints.
6.4 What information to expect in a paper describing an RCT: the
CONSORT statement.
6.5 Getting worthwhile evidence out of a pharmaceutical
representative.
7 Papers that report trials of complex interventions.
7.1 Complex interventions.
7.2 Ten questions to ask about a paper describing a complex
intervention.
8 Papers that report diagnostic or screening tests.
8.1 Ten men in the dock.
8.2 Validating diagnostic tests against a gold standard.
8.3 Ten questions to ask about a paper that claims to validate a
diagnostic or screening test.
8.4 Likelihood ratios.
8.5 Clinical prediction rules.
9 Papers that summarise other papers systematic reviews and
meta-analyses.
9.1 When is a review systematic?
9.2 Evaluating systematic reviews.
9.3 Meta-analysis for the non-statistician.
9.4 Explaining heterogeneity.
9.5 New approaches to systematic review.
10 Papers that tell you what to do guidelines.
10.1 The great guidelines debate.
10.2 How can we help ensure that evidence-based guidelines are
followed?
10.3 Ten questions to ask about a clinical guideline.
11 Papers that tell you what things cost economic analyses.
11.1 What is an economic analysis?
11.2 Measuring the costs and benefits of health
interventions.
11.3 Ten questions to ask about an economic analysis.
11.4 Conclusion.
12 Papers that go beyond numbers qualitative research.
12.1 What is qualitative research?
12.2 Evaluating papers that describe qualitative research.
12.3 Conclusion.
13 Papers that report questionnaire research.
13.1 The rise and rise of questionnaire research.
13.2 Ten questions to ask about a paper describing a questionnaire
study.
14 Papers that report quality improvement case studies.
14.1 What are quality improvement studies – and how should we
research them?
14.2 Ten questions to ask about a paper describing a quality
improvement initiative.
14.3 Conclusion.
15 Getting evidence into practice.
15.1 Why are health professionals slow to adopt evidence-based
practice?
15.2 How much avoidable suffering is caused by failing to implement
evidence?
15.3 How can we influence health professionals'' behaviour to
promote evidence-based practice?
15.4 What does an ''evidence-based organisation'' look like?
15.5 How can we help organisations develop the appropriate
structures, systems and values to support evidence-based
practice?
15.6 Why is it so hard to get evidence into policymaking?
Appendix 1 Checklists for finding, appraising and implementing
evidence.
Appendix 2 Assessing the effects of an intervention.
Index.
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