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How to Read a Paper
The Basics of Evidence–Based Medicine
Series: How - How to
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Main description:

The best–selling introduction to evidence–based medicine

In a clear and engaging style, How to Read a Paper demystifies evidence–based medicine and explains how to critically appraise published research and also put the findings into practice.

An ideal introduction to evidence–based medicine, How to Read a Paper explains what to look for in different types of papers and how best to evaluate the literature and then implement the findings in an evidence–based, patient–centred way. Helpful checklist summaries of the key points in each chapter provide a useful framework for applying the principles of evidence–based medicine in everyday practice.

This fifth edition has been fully updated with new examples and references to reflect recent developments and current practice. It also includes two new chapters on applying evidence–based medicine with patients and on the common criticisms of evidence–based medicine and responses.

How to Read a Paper is a standard text for medical and nursing schools as well as a friendly guide for everyone wanting to teach or learn the basics of evidence–based medicine.


Back cover:

The best–selling introduction to evidence–based medicine

In a clear and engaging style, How to Read a Paper demystifies evidence–based medicine and explains how to critically appraise published research and also put the findings into practice.

An ideal introduction to evidence–based medicine, How to Read a Paper explains what to look for in different types of papers and how best to evaluate the literature and then implement the findings in an evidence–based, patient–centred way. Helpful checklist summaries of the key points in each chapter provide a useful framework for applying the principles of evidence–based medicine in everyday practice.

This fifth edition has been fully updated with new examples and references to reflect recent developments and current practice. It also includes two new chapters on applying evidence–based medicine with patients and on the common criticisms of evidence–based medicine and responses.

How to Read a Paper is a standard text for medical and nursing schools as well as a friendly guide for everyone wanting to teach or learn the basics of evidence–based medicine.


Contents:

Foreword to the first edition by Professor Sir DavidWeatherall, xiii

Preface to the first edition: do you need to read this book? xvii


Preface to the fifth edition, xix


Acknowledgements, xxi


Chapter 1 Why read papers at all? 1


Does evidence–based medicine simply mean reading papers in medical journals ? 1


Why do people sometimes groan when you mention evidence–based medicine? 4


Before you start: formulate the problem, 10


References, 13


Chapter 2 Searching the literature, 15


What are you looking for? 16


Levels upon levels of evidence, 17


Synthesised sources: systems, summaries and syntheses, 17


Pre–appraised sources: synopses of systematic reviews and primary studies, 21


Specialised resources, 22


Primary studies tackling the jungle, 23


One–stop shopping: federated search engines, 24


Asking for help and asking around, 25


Online tutorials for effective searching, 26


References, 26


Chapter 3 Getting your bearings: what is this paper about? 28


The science of trashing papers, 28


Three preliminary questions to get your bearings, 30


Randomised controlled trials, 34


Cohort studies, 38


Case control studies, 39


Cross–sectional surveys, 40


Case reports, 40


The traditional hierarchy of evidence, 41


A note on ethical considerations, 42


References, 43


Chapter 4 Assessing methodological quality, 45


Was the study original? 45


Whom is the study about? 46


Was the design of the study sensible? 47


Was systematic bias avoided or minimised? 49


Was assessment blind ? 53


Were preliminary statistical questions addressed? 54


Summing up, 57


References, 58


Chapter 5 Statistics for the non–statistician, 60


How can non–statisticians evaluate statistical tests? 60


Have the authors set the scene correctly? 62


Paired data, tails and outliers, 68


Correlation, regression and causation, 70


Probability and confidence, 72


The bottom line, 74


Summary, 76


References, 76


Chapter 6 Papers that report trials of drug treatments and other simple interventions, 78


Evidence and marketing, 78


Making decisions about therapy, 80


Surrogate endpoints, 81


What information to expect in a paper describing a randomised controlled trial: the CONSORT statement, 84


Getting worthwhile evidence out of a pharmaceutical representative, 86


References, 88


Chapter 7 Papers that report trials of complex interventions, 90


Complex interventions, 90


Ten questions to ask about a paper describing a complex intervention, 92


References, 97


Chapter 8 Papers that report diagnostic or screening tests, 99


Ten men in the dock, 99


Validating diagnostic tests against a gold standard, 100


Ten questions to ask about a paper that claims to validate a diagnostic or screening test, 105


Likelihood ratios, 110


Clinical prediction rules, 111


References, 113


Chapter 9 Papers that summarise other papers (systematic reviews and meta–analyses), 116


When is a review systematic? 116


Evaluating systematic reviews, 119


Meta–analysis for the non–statistician, 124


Explaining heterogeneity, 128


New approaches to systematic review, 132


References, 132


Chapter 10 Papers that tell you what to do (guidelines), 135


The great guidelines debate, 135


How can we help ensure that evidence–based guidelines are followed? 138


Ten questions to ask about a clinical guideline, 141


References, 148


Chapter 11 Papers that tell you what things cost (economic analyses), 150


What is economic analysis? 150


Measuring costs and benefits of health interventions, 151


References, 162


Chapter 12 Papers that go beyond numbers (qualitative research), 164


What is qualitative research? 164


Evaluating papers that describe qualitative research, 168


References, 176


Chapter 13 Papers that report questionnaire research, 178


The rise and rise of questionnaire research, 178


Ten questions to ask about a paper describing a questionnaire study, 179


References, 188


Chapter 14 Papers that report quality improvement case studies, 190


What are quality improvement studies and how should we research them? 190


Ten questions to ask about a paper describing a quality improvement initiative, 193


References, 200


Chapter 15 Getting evidence into practice, 202


Why are health professionals slow to adopt evidence–based practice? 202


How much avoidable suffering is caused by failing to implement evidence? 204


How can we influence health professionals behaviour to promote evidence–based practice? 205


What does an evidence–based organisation look like? 210


How can we help organisations develop the appropriate structures, systems and values to support evidence–based practice? 212


References, 217


Chapter 16 Applying evidence with patients, 221


The patient perspective, 221


PROMs, 223


Shared decision–making, 224


Option grids, 226


n of 1 trials and other individualised approaches, 229


References, 230


Chapter 17 Criticisms of evidence–based medicine, 233


What s wrong with EBM when it s done badly? 233


What s wrong with EBM when it s done well? 235


Why is evidence–based policymaking so hard to achieve? 238


References, 240


Appendix 1 Checklists for finding, appraising and implementing evidence, 242


Appendix 2 Assessing the effects of an intervention, 252


Index, 253


PRODUCT DETAILS

ISBN-13: 9781118801116
Publisher: John Wiley & Sons Ltd (Wiley–Blackwell)
Publication date: March, 2014
Pages: 280
Dimensions: 138.00 x 216.00 x 13.03

Subcategories: Diseases and Disorders, General Issues

MEET THE AUTHOR

Trisha Greenhalgh OBE, FRCGP, FRCP, Professor of Primary Health Care and Dean for Research Impact, Barts and the London School of Medicine and Dentistry, London, UK