How to Read a Paper: The Basics of Evidence-Based Medicine

How to Read a Paper......Page 5
Table of Contents......Page 7
Foreword to the First Edition......Page 11
Preface to the First Edition: do you need to read this book?......Page 14
Preface to the Fourth Edition......Page 16
Acknowledgements......Page 18
1.1 Does \'evidence-based medicine\' simply mean \'reading papers in medical journals\'?......Page 21
1.2 Why do people sometimes groan when you mention EBM?......Page 23
1.3 Before you start: formulate the problem......Page 29
2 Searching the literature......Page 35
2.1 What are you looking for?......Page 36
2.2 Levels upon levels of evidence......Page 38
2.3 Synthesised sources: systems, summaries and syntheses......Page 39
2.5 Specialised resources......Page 43
2.6 Primary studies – tackling the jungle......Page 44
2.8 Asking for help and asking around......Page 48
3.1 The science of \'trashing\' papers......Page 51
3.2 Three preliminary questions to get your bearings......Page 53
3.3 Randomised controlled trials......Page 56
3.4 Cohort studies......Page 60
3.5 Case-control studies......Page 61
3.7 Case reports......Page 62
3.8 The traditional hierarchy of evidence......Page 63
3.9 A note on ethical considerations......Page 64
4.1 Was the study original?......Page 67
4.2 Whom is the study about?......Page 68
4.3 Was the design of the study sensible?......Page 69
4.4 Was systematic bias avoided or minimised?......Page 71
4.5 Was assessment \'blind\'?......Page 74
4.6 Were preliminary statistical questions addressed?......Page 75
4.7 Summing up......Page 78
5.1 How can non-statisticians evaluate statistical tests?......Page 81
5.2 Have the authors set the scene correctly?......Page 82
5.3 Paired data, tails, and outliers......Page 88
5.4 Correlation, regression and causation......Page 90
5.5 Probability and confidence......Page 92
5.6 The bottom line......Page 94
5.7 Summary......Page 96
6.1 \'Evidence\' and marketing......Page 98
6.2 Making decisions about therapy......Page 100
6.3 Surrogate endpoints......Page 101
6.5 Getting worthwhile evidence out of a pharmaceutical representative......Page 104
7.1 Complex interventions......Page 110
7.2 Ten questions to ask about a paper describing a complex intervention......Page 112
8.1 Ten men in the dock......Page 118
8.2 Validating diagnostic tests against a gold standard......Page 119
8.3 Ten questions to ask about a paper that claims to validate a diagnostic or screening test......Page 123
8.4 Likelihood ratios......Page 128
8.5 Clinical prediction rules......Page 129
9.1 When is a review systematic?......Page 133
9.2 Evaluating systematic reviews......Page 136
9.3 Meta-analysis for the non-statistician......Page 141
9.4 Explaining heterogeneity......Page 145
9.5 New approaches to systematic review......Page 148
10.1 The great guidelines debate......Page 152
10.2 How can we help ensure that evidence-based guidelines are followed?......Page 155
10.3 Ten questions to ask about a clinical guideline......Page 159
11.1 What is an economic analysis?......Page 169
11.2 Measuring the costs and benefits of health interventions......Page 171
11.3 Ten questions to ask about an economic analysis......Page 176
11.4 Conclusion......Page 180
12.1 What is qualitative research?......Page 183
12.2 Evaluating papers that describe qualitative research......Page 187
12.3 Conclusion......Page 194
13.1 The rise and rise of questionnaire research......Page 197
13.2 Ten questions to ask about a paper describing a questionnaire study......Page 198
14.1 What are quality improvement studies – and how should we research them?......Page 208
14.2 Ten questions to ask about a paper describing a quality improvement initiative......Page 210
14.3 Conclusion......Page 217
15.1 Why are health professionals slow to adopt evidence-based practice?......Page 219
15.2 How much avoidable suffering is caused by failing to implement evidence?......Page 221
15.3 How can we influence health professionals\' behaviour to promote evidence-based practice?......Page 222
15.4 What does an \'evidence-based organisation\' look like?......Page 228
15.5 How can we help organisations develop the appropriate structures, systems and values to support evidence-based practice?......Page 229
15.6 Why is it so hard to get evidence into policymaking?......Page 234
Appendix 1 Checklists for finding, appraising and implementing evidence......Page 241
Appendix 2 Assessing the effects of an intervention......Page 250
C......Page 251
D......Page 252
F......Page 253
I......Page 254
P......Page 255
Q......Page 256
S......Page 257
Y......Page 258