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Zusatztext 'Where's the evidence? published by Oxford University Press, contains 45 essays which first appeared in Paediatric and Epidemiology, brought up to date with current comments and annotation, some by the author and some by other experts. To open a page and start reading is to be enthralled...Silverman takes up difficult problems. He does not always solve them, but he does offer challenging and sometimes unconvential points of view...Do obtain a copy, dip into it, and enjoy yourself while you stretch your mind.' Klappentext Medicine is moving away from reliance on the proclamations of authorities to the use of numerical methods to estimate the size of effects of its interventions. But a rumbling note of uneasiness underlines present-day medical progress: the more we know! The more questions we encounter aboutwhat to do with the hard-won information. The essays in Where's the Evidence examine the dilemmas that have arisen as the result of medicine's unprecedented increase in technical powers. How do doctors draw the line between "knowing" (the acquisition of new medical information) and doing" (the application of that new knowledge)? What arethe long-term consequences of responding to the demand that physicians always do everything that can be done? Is medicine's primary aim to increase the length of life? Or is it to reduce the amount of pain and suffering? And who is empowered to choose when these ends are mutually exclusive? Thisengaging collection of essays will be of interest to professionals interested in the evidence-based medicine debate! including epidemiologists! neonatologists! those involved in clinical trials and health policy! medical ethicists! medical students! and trainees. Zusammenfassung This work is a collection of critical and controversial essays discussing intractable ethical issues and evidence-based problems in modern medicine. The author questions how medical disasters can be avoided by more rigorous trials of new medical technology, using many case studies as examples. Inhaltsverzeichnis Foreword by David L. Sackett Preface List of Respondents Introduction 1: Selective ethics 2: Does a difference make a difference 3: Prescription for disaster 4: Therapeutic mystique 5: Humane limits 6: Intruding in private tragedies 7: The glut of information 8: Betting on specified horses 9: Begin with 'if...' 10: Archie's scepticism 11: Arbitrary vs discretionary decisions 12: Bioengineering 13: '...disavowing the tree' 14: Diffusing responsibility Weil's reply 15: Hawthorne effects 16: Power plays 17: Unbridled enthusiasm 18: Caring and curing 19: On the edge 20: Informing and consenting Weil's reply 21: Lifesavers 22: Belief and disbelief 23: Preferences 24: Bradford Hill's doubts 25: More-informative abstracts 26: Pain control in neonates 27: Miraculous cures 28: Observer bias 29: The gamekeeper's brouhaha 30: Champing at the bit 31: Piecemeal skirmishes 32: Resolution of dilemma's Sinclair and Fowlie's reply Watts and Saigal's reply 33: 'Fixing' human reproduction 34: Justice defined as fairness 35: 'Methods-based' reviews 36: Non-replication of the replicable 37: Who defines 'futility' Goldworth and Benitz's reply 38: Fitting targets in holes 39: Medical 'manners' on trial 40: Sanction of whose beliefs and values? 41: Mindness existence 42: Interventions on an unprecedented scale 43: Preoccupation with 'autonomy' 44: A 'win' in medical Russian Roulette Lantos' reply Citations Bibliography Index ...
