By Bengt D. Furberg MD, PhD, Curt D. Furberg MD, PhD (auth.)
The goal of this publication is to make its readers higher trained and extra serious shoppers of scientific study to aid them realize the strengths and the weaknesses of clinical courses. In doing so, the reader may be capable of distinguish patient-important and methodologically sound stories from these having boundaries in layout, behavior and interpretation.
There aren't any necessities for examining this publication. The textual content is uncomplicated and has no statistical formulation. Key take-home messages are indexed on the finish of every bankruptcy. the massive variety of cartoons has reasons: First, to make the textual content more uncomplicated to learn and generate a number of laughs and, moment, to underscore particular issues, occasionally in a provocative way.
Bengt D. Furberg, MD, PhD is board-certified in inner drugs. After spending a decade as scientific director within the pharmaceutical undefined, he now serves as scientific advisor, comparing the protection and efficacy of pharmaceutical items and clinical units and selling evidence-based medication. His brother, Curt D. Furberg, MD, PhD, is Professor within the department of Public wellbeing and fitness Sciences, Wake woodland collage tuition of medication, Winston-Salem, NC, united states. After arriving within the usa from Sweden, he labored on the nationwide middle, Lung, and Blood Institute of the nationwide Institutes of future health for 12 years. he's co-author of Fundamentals of medical Trials with Lawrence M. Friedman and David L. DeMets. His parts of curiosity are medical trials, evidence-based drugs and drug security. The authors have bought a lot in their wisdom approximately scientific experiences throughout the "trial and mistake" technique. therefore, they've got own adventure with the various difficulties they describe.
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Additional info for evaluating clinical research: All that glitters is not gold
This so-called “indication bias” must be considered in observational studies. Conversely, drug use can also be a marker of “healthy” users — patients who are less sick. For decades, we were led to believe that hormone replacement therapy (HRT) reduced the risk of coronary events. 3 Although reports indicated that users were healthier, had fewer risk factors and saw their physicians more often, the observation was not accepted until randomized clinical trials1,7 provided no evidence that HRT is cardioprotective.
8 High proportions of meaningless entries in the “Intervention Name” field, 21 and 11%, respectively, were noted for two major companies. The “Primary Outcome” field was only completed 3% of the time by a third company. Chapter 8 - Were the scientific questions stated in advance? Key Points A clinical trial should have one pre-specified, primary hypothesis. When the results for the primary hypothesis are not significant, be cautious if the focus is shifted to a secondary endpoint, or one that is defined post hoc.
2 Habitual smoking shortened the lifespan by about 10 years. What is the potential value of disease registries? We have recently seen an increase in the number of large disease- and condition-specific registries, as well as registries of patients undergoing particular procedures. These are often part of larger electronic databases, which link to pharmacy records. These have been helpful in identifying both favorable and unfavorable long-term effects of various interventions. For example, information on drug utilization by pregnant women has proven valuable when linked to a registry of congenital birth defects.