Critical Appraisal of Epidemiological Studies and Clinical Trials

Paperback | March 19, 2007

byJ. Mark Elwood

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This book presents a logical system of critical appraisal, to allow readers to evaluate studies and to carry out their own studies more effectively. This system emphasizes the central importance of cause and effect relationships. Its great strength is that it is applicable to a wide range ofissues, and both to intervention trials and observational studies. This system unifies the often different approaches used in epidemiology, health services research, clinical trials, and evidence-based medicine, starting from a logical consideration of cause and effect. The author's approach to the issues of study design, selection of subjects, bias, confounding,and the place of statistical methods has been praised for its clarity and interest. Systematic reviews, meta-analysis, and the applications of this logic to evidence-based medicine, knowledge-based health care, and health practice and policy are discussed. Current and often controversial examplesare used, including screening for prostate cancer, publication bias in psychiatry, public health issues in developing countries, and conflicts between observational studies and randomized trials. Statistical issues are explained clearly without complex mathematics, and the most useful methods aresummarized in the appendix. The final chapters give six applications of the critical appraisal of major studies: randomized trials of medical treatment and prevention, a prospective and a retrospective cohort study, a small matched case-control study, and a large case-control study. In these chapters, sections of the originalpapers are reproduced and the original studies placed in context by a summary of current developments.

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This book presents a logical system of critical appraisal, to allow readers to evaluate studies and to carry out their own studies more effectively. This system emphasizes the central importance of cause and effect relationships. Its great strength is that it is applicable to a wide range ofissues, and both to intervention trials and o...

Mark Elwood is an epidemiologist with particular interests in cancer prevention, screening, and evidence-based medicine. He has worked in three continents and trained in Belfast, in Ottawa and at Harvard. He has recently returned to the British Columbia Cancer Agency, Vancouver, where he was the first Head of Epidemiology. He has been...

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Format:PaperbackDimensions:584 pages, 9.21 × 6.14 × 1.38 inPublished:March 19, 2007Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0198529554

ISBN - 13:9780198529552

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Extra Content

Table of Contents

1. The importance of causal relationships in medicine and health care2. Study designs which can demonstrate and test causation3. The results obtained from studies of causation4. Selection of subjects for study5. Error and bias in observations6. Confounding7. Chance variation8. Combining results from several studies: systematic review and meta-analysis9. The diagnosis of causationCritical appraisal in action - introduction to Chapters 10 to 1510. Critical appraisal of a randomized clinical trial11. Critical appraisal of a randomized trial of a preventive agent12. Critical appraisal of a prospective cohort study13. Critical appraisal of a retrospective cohort study14. Critical appraisal of a matched case-control study15. Critical appraisal of a large, population based, case-control studyAnswers to self test questionsAppendix: Methods of statistical analysis: formulae and worked examples

Editorial Reviews

"The premise of the book is laudable in that critical thinking and evaluation of peer-reviewed literature is imperative in the training of public health and clinical researchers. In general, the book lays a foundation, establishes the issues of bias and bias control, and provides a framework for evaluation with examples."--Doody's