Up From Clinical Epidemiology Ebm

‘Clinical epidemiology’ is now widely promoted and taught as a ‘basic science’ of Evidence-Based Medicine, of clinical EBM to be specific. This book, however, is mostly about that which Miettinen takes to be the necessary substitute for this now-so-fashionable subject – namely, Theory of Clinical Medicine together with its subordinate Theory of Clinical Research. The leit motif in all of this is Miettinen’s perception of the need, and opportunity, to bring major improvements into clinical medicine in this Information Age, now that theoretical progress has made feasible the development of practice-guiding Expert Systems for it. Parts of this text constitute essential reading for whoever is expected, or otherwise inclined, to study – or teach – ‘clinical epidemiology,’ and the same is true of those who set policy for the education of future clinicians; but practically all of it is essential reading for future – and current – academics in the various disciplines of clinical medicine. After all, the text is the result of a concentrated effort, over a half-century no less, to really understand both clinical and community medicine and the research to advance the knowledge-base of these. Research epidemiologists, too, will find this text interesting and instructive.

This comprehensive text focuses on reasoning, critical thinking and pragmatic decision making in medicine. Based on the author’s extensive experience and filled with definitions, formulae, flowcharts and checklists, this fully revised second edition continues to provide invaluable guidance to the crucial role that clinical epidemiology plays in the expanding field of evidence-based medicine. Key Features: • Considers evidence-based medicine as a universal initiative common to all health sciences and professions, and all specialties within those disciplines • Demonstrates how effective practice is reliant on proper foundations, such as clinical and fundamental epidemiology, and biostatistics • Introduces the reader to basic epidemiological methods, meta-analysis and decision analysis • Shows that structured, modern, argumentative reasoning is required to build the best possible evidence and use it in practice and research • Outlines how to make the most appropriate decisions in clinical care, disease prevention and health promotion Presenting a range of topics seldom seen in a single resource, the innovative blend of informal logic and structured evidence-based reasoning makes this book invaluable for anyone seeking broad, in-depth and readable coverage of this complex and sometimes controversial field.

Having last year published “Up from Clinical Epidemiology & EBM” and also “Epidemiological Research: Terms and Concepts,” Miettinen now – this time with collaboration from his junior colleague I. Karp – brings out this further introduction into epidemiological research; and he is now working on an introduction into clinical research, for publication next year. It evidently is Miettinen’s felt time to crystallize the basic understandings he has come to as the culmination of a half-century of concentrated effort to advance the theory of epidemiological and ‘meta-epidemiological clinical’ research. In accord with its title, this book focuses on research to develop the knowledge-base for preventive medicine, which mainly is knowledge about the causal origin –etilogy, etiogenesis – of illness. It first illustrates how wanting this knowledge still is, despite much research; and it then aims to guide the reader to more productive etiogenetic research. This book places much emphasis on the need to assure relevance by principles-guided objects design for the studies, which now remains conspicuously absent from epidemiologists’ concerns. And as for methods design, this book exposes the fallacies in the still-common ‘cohort’ and ‘case-control’ studies, defines the essentials of all etiogenetic studies, and then addresses the true options for design in this framework of shared essentials. A good deal of attention is also given to the still commonly-held, very major, twin fallacies that screening for an illness is a preventive intervention, to be studied by randomized trials, and that research on it can imply rational guidelines or recommendations regarding decisions about the screening. While Miettinen already is regarded as ‘the father of modern epidemiology,’ he now appears to have become the father also of post-modern epidemiology, where ‘epidemiology’ still means epidemiological research.

Using clinical examples and citing liberally from the peer-reviewed literature, this book shows how statistical priniciples can improve medical decisions.

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. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.

The book is organized so as to address in separate sections first the preparatory topics of medicine (clinical and epidemiological), science in general, and statistics (mathematical); then topics of epidemiological research proper; and, finally, topics of ‘meta-epidemiological’ clinical research. In those two main sections, a further grouping is based on the distraction between objects and methods of study. In this framework, the particular topics are addressed both descriptively and quasi-prescriptively, commonly with a number of explicatory annotations. This book is intended to serve as a handbook for whomever is, in whatever way, concerned with epidemiological or ‘meta-epidemiological’ clinical research. But besides this, it is also intended to serve as a textbook for students in introductory courses on ‘epidemiological’ research – to which end there is a suggested hierarchy of the concepts that might reasonably be covered.

Translating the evidence from the bedside to populations This sixth edition of the best-selling Epidemiology, Evidence-based Medicine and Public Health Lecture Notes equips students and health professionals with the basic tools required to learn, practice and teach epidemiology and health prevention in a contemporary setting. The first section, 'Epidemiology', introduces the fundamental principles and scientific basis behind work to improve the health of populations, including a new chapter on genetic epidemiology. Applying the current and best scientific evidence to treatment at both individual and population level is intrinsically linked to epidemiology and public health, and has been introduced in a brand new second section: ‘Evidence-based Medicine’ (EBM), with advice on how to incorporate EBM principles into your own practice. The third section, 'Public Health', introduces students to public health practice, including strategies and tools used to prevent disease, prolong life, reduce inequalities, and includes global health. Thoroughly updated throughout, including new studies and cases from around the globe, key learning features include: Learning objectives and key points in every chapter Extended coverage of critical appraisal and data interpretation A brand new self-assessment section of SAQs and 'True/False' questions for each topic A glossary to quickly identify the meaning of key terms, all of which are highlighted for study and exam preparation Further reading suggestions on each topic Whether approaching these topics for the first time, starting a special study module or placement, or looking for a quick-reference summary, this book offers medical students, junior doctors, and public health students an invaluable collection of theoretical and practical information.

The accompanying CD-ROM contains clinical examples, critical appraisals and background papers.

This book is a comprehensive and practical introduction of clinical epidemiology for students and practitioners. It covers both the basic principles and concepts of clinical epidemiology as well as its applications in various medical disciplines. It covers how to design, conduct, and interpret clinical studies using methods such as bias analysis, confounding control, causality assessment, diagnosis evaluation, prognosis prediction treatment comparison, and meta-analysis in this book. It also introduces how to apply these skills to real-world scenarios through case studies and examples that provide a fresh perspective on familiar topics. This book is a useful textbook for graduate and undergraduate students in medical schools, including MBBS (Bachelor of Medicine and Bachelor of Surgery) student.

Explains the mathematics involved in understanding and choosing an array of diagnostic and prognostic tests, in order to improve treatment.