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Therapeutics, Evidence and Decision-Making



ISBN 9781853159473
Published July 28, 2011 by CRC Press
256 Pages

 
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Book Description

This book is intended to help decision-makers use, assess and appraise the evidence that underpins decisions about the use of therapeutic interventions. It will inform decision-makers about the nature of evidence, the strengths and weaknesses of the available approaches, and how these can be most effectively distilled for the purpose of reaching reliable conclusions. It aims to encourage decision-makers to base their judgements about the use of therapeutic interventions on an informed appraisal of the totality of the evidence base. Is it reliable? Is it generalisable beyond the context of the environment in which the primary research has been conducted? Do the intervention's benefits outweigh its harms? Is it cost effective as well as clinically effective? Is it, indeed, fit-for-purpose? Ultimately, good judgement is at the heart of decision-making in therapeutics.

An invaluable text for all physicians, pharmacists, nurses, health commissioners and purchasers and indeed anyone having to make decisions concerning evidence-based therapeutics.

Table of Contents

Introduction
The nature of evidence
Probability
Clinical endpoints of benefits and harms
Statistical expressions of benefit and harm
Bias and confounding
Systematic reviews

Randomized controlled trials
General principles
Stopping rules
Analysis of subgroups
Safety
Generalizability

Observational studies
General overview
Historical controlled trials
Concurrent cohort studies
Case-control designs
Databases
Case reports

Qualitative research
Approaches and methods
Uses in the evaluation of therapeutic interventions

Economic evaluation
General principles
Cost-effectiveness, cost-utility and cost-minimization analyses
Cost-consequences analysis

Decision-making
For individuals
For populations

...
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Author(s)

Biography

"Professor Sir Michael Rawlins MD FRCP(Lond) FRCP(Edin) FFPM FMedSci, National Institute for Clinical Excellence, London, UK

"