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Informationen zum Autor Jeremy Howick PhD Centre for Evidence-Based Medicine, Department of Primary Care, University of Oxford, UK Klappentext The controversy surrounding the significance of evidence-based medicine (EBM) in clinical practice, far from abating, has grown and developed a momentum of its own. This book examines the arguments for and against EBM being a new paradigm in medicine, and puts together the most coherent and compelling case as to how and why its rigor should be applied to every facet of patient care; discussing the questions often raised by critics of evidence-based medicine: Why should EBM dominate health care, from daily medical practice to funding treatments? Is it truly objective? Do we need randomized trials for treatments that are universally accepted as effective? Does EBM serve the needs of individual patients? What part do basic sciences play in EBM? Are randomized trials more important than clinical experts? Students of evidence-based medicine, researchers and those studying the philosophy of science or medicine will find this detailed treatise an invaluable reference to the development of EBM, from recognition of the validity of randomized controlled trials to today's more patient-centred approach. Titles of Related Interest Clinical Thinking: Evidence, Communication and Decision-Making Chris Del Mar, Jenny Doust, Paul P. Glasziou ISBN: 978-0-7279-1741-6 Evidence-based Decisions and Economics: Health care, social welfare, education and criminal justice, 2nd Edition Ian Shemilt, Miranda Mugford, Luke Vale, Kevin Marsh and Cam Donaldson ISBN 978-1-4051-9153-1 Zusammenfassung Evidence-based medicine (EBM) has become a required element of clinical practice! but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Inhaltsverzeichnis Acknowledgments. Foreword. Preface. Part I: Introduction. 1 The philosophy of evidence-based medicine. 1.1 What on earth was medicine based on before evidence-based medicine? 1.2 Scope of the book. 1.3 How the claims of EBM will be examined. 1.4 Structure of what is to come. 2 What is EBM? 2.1 EBM as a self-proclaimed Kuhnian paradigm. 2.2 The motivation for the birth of EBM: a sketch. 2.3 Original definition of EBM. 2.4 Reaction to criticism of the EBM system of evidence: more subtle, more or less the same. 3 What is good evidence for a clinical decision? 3.1 Introduction. 3.2 Evidence for clinical effectiveness. 3.3 Strong evidence tells us what? Part II: Do randomization, double masking, and placebo controls rule out more confounding factors than their alternatives? 4 Ruling out plausible rival hypotheses and confounding factors: a method. 5 Resolving the paradox of effectiveness: when do observational studies offer the same degree of evidential support as randomized trials? 5.1 The paradox of effectiveness. 5.2 Observational studies: defi nition and problems. 5.3 Randomized trials to the rescue. 5.4 Defending the EBM view that randomized trials provide better evidence than observational studies. 5.5 Overcoming the paradox of effectiveness. 5.6 Conclusion: a more subtle way to distinguish between high- and low-quality comparative clinical studies. Appendix 1: types of restricted randomization. Appendix 2: Worrall's arguments that randomization is required for classical hypothesis testing and establishing probabilistic causes. 6 Questioning double blinding as a universal methodological virtue of clinical trials: resolving the Philip's paradox. 6.1 The problems with double masking as a requirement...
