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Essential Evidence-Based Medicine


  • 106 b/w illus. 40 tables
  • Page extent: 392 pages
  • Size: 246 x 189 mm
  • Weight: 0.882 kg

Mixed media product

 (ISBN-13: 9780521540278 | ISBN-10: 0521540275)

Evidence Based Medicine (EBM), using the best evidence in the literature for the best care for an individual patient, sounds very simple. Yet, most medical students and physicians do not have the mathematical background or training to critically evaluate published research. This 'users guide' to EBM helps you become a more discriminating reader of the medical literature. An introduction to scientific methods and study design then leads on to a better understanding of measurements and sources of bias. There is a brief introduction to statistics and hypothesis testing (Type I and II errors) and measures of risk and efficacy. The second half of the book teaches medical decision-making including discussions of the clinical examination and sources of bias in that examination, likelihood ratios, sensitivity, specificity, and predictive values and advanced topics in medical decision making. This is an ideal introductory text for medical students and all health-care professionals.

• An accessible and ideal introduction to EBM for non-mathematically inclined students and all consumers of medical research • Accompanied by an interactive and fun-to-use CD-ROM consisting of practice problems and journal articles that reinforce the concepts taught in the book • Also includes advanced topics in medical decision-making to help practitioners who may understand basic concepts of critical appraisal but would like to have more information about tying them together in the medical decision-making process


Preface; 1. A brief history of medicine and statistics; 2. What is evidence based?; 3. Causation; 4. The medical literature: an overview; 5. Searching the medical literature; 6. Study design and strength of evidence; 7. Instruments and measurements: precision and validity; 8. Sources of bias; 9. Review of basic statistics; 10. Hypothesis testing; 11. Type I errors and number needed to treat; 12. Negative studies and type II errors; 13. Risk assessment; 14. Multivariate analysis; 15. Randomized clinical trials (RCTs); 16. Scientific integrity and the responsible conduct of research; 17. Applicability and strength of evidence; 18. An overview of decision making in medicine; 19. Sources of error in the clinical encounter; 20. The use of diagnostic tests; 21. Utility and characteristics of diagnostic tests: likelihood ratios, sensitivity and specificity; 22. Bayes' theorem, predictive values, post test probabilities and interval likelihood ratios; 23. Comparing tests and using ROC curves; 24. Incremental gain and the threshold approach to diagnostic testing; 25. Sources of bias and critical appraisal of studies of diagnostic tests; 26. Screening tests; 27. Practice guidelines and clinical prediction rules; 28. Decision analysis; 29. Cost effective analysis; 30. Outcome analysis; 31. Meta-analysis; Appendix 1. Common medical journals; Appendix 2. Glossary; Appendix 3. Bibliography; Appendix 4. Levels of evidence and grades of recommendations; Appendix 5. Overview of critical appraisal; Appendix 6. Common statistical tests; Appendix 7. Useful Web sites; Appendix 8. Formulae; Appendix 9. Proof of Bayes' Theorem; Appendix 10. Balance sheet approach to calculating threshold values; Index.


'… highly accurate, and easy to read textbook about EBM, suitable for all lifelong learners of medicine. Modestly titled 'Essential,' it contains much more than the essentials. It contains-and conveys-true understanding.'

'Everything is covered, and having mastered this, students will know a lot. Yet the skill in teaching shines through. … So it can be used in a variety of ways. I will use it as a reference text for epidemiology and statistics, and use some of the clinical examples. I think I will also make use of the assessment CD to design material for our students. Others could use it as a self-contained text to learn the introductory skills on their own. It is certainly up to that.' Statistics in Medicine

'The author is an EBM expert who provides an excellent overview and practical approach to the topic. the book includes a history of medicine and statistics and a thought provoking essay on what constitutions EBM. Several chapters are dedicated to topics that would normally require reading in additional textbooks, thereby making this an all-in-one resource … the text is well organised and offers comprehensive information on EBM.' EBM Online

'… an excellent overview of evidence-based medicine which has been thoroughly updated since the previous edition. Once you have read this book thoroughly you will know most of what you need to know about evidence-based medicine and be in a position to think carefully about its applications in the real world. The book should be a key core text book for medical students and for those undertaking masters-level training in public health or evidence-based practice and it should be a compulsory handbook for practising clinicians!' European Journal of Public Health

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