Therapeutics, Evidence and Decision-Making
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
The nature of evidence
Clinical endpoints of benefits and harms
Statistical expressions of benefit and harm
Bias and confounding
Randomized controlled trials
Analysis of subgroups
Historical controlled trials
Concurrent cohort studies
Approaches and methods
Uses in the evaluation of therapeutic interventions
Cost-effectiveness, cost-utility and cost-minimization analyses
"Professor Sir Michael Rawlins MD FRCP(Lond) FRCP(Edin) FFPM FMedSci, National Institute for Clinical Excellence, London, UK