Therapeutics, Evidence and Decision-Making
This book is intended to help decision-makers use, assess and appraise the evidence that underpins decisions about the use of therapeutic interventions. It will inform decision-makers about the nature of evidence, the strengths and weaknesses of the available approaches, and how these can be most effectively distilled for the purpose of reaching reliable conclusions. It aims to encourage decision-makers to base their judgements about the use of therapeutic interventions on an informed appraisal of the totality of the evidence base. Is it reliable? Is it generalisable beyond the context of the environment in which the primary research has been conducted? Do the intervention's benefits outweigh its harms? Is it cost effective as well as clinically effective? Is it, indeed, fit-for-purpose? Ultimately, good judgement is at the heart of decision-making in therapeutics.
An invaluable text for all physicians, pharmacists, nurses, health commissioners and purchasers and indeed anyone having to make decisions concerning evidence-based therapeutics.
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adverse drug reactions adverse events allocation Altman DG analysis approach aspirin associated Bayesian benefits and harms bias and confounding breast cancer cardiovascular case–control studies cent Chapter 1.4 chronic Clinical Excellence clinical trials cohort studies compared comparisons conclusions condition confidence interval cost-effectiveness costs databases death decision-makers decisions differences discussed economic evaluation effects of interventions endpoint England Journal estimate evidence example factors generalizability hazard ratio Health and Clinical healthcare system historical controlled trials hormone replacement therapy imatinib incremental cost–effectiveness ratio indication individual Institute for Health intervention’s investigators judgements Lancet life-year meta-analysis methods mortality null hypothesis number needed observational studies odds ratio outcomes overall P-value particular intervention patients pioglitazone placebo population potential probability QALY qualitative research randomised randomized controlled trials randomized trials rates Rawlins MD reduce registries relative risk relevant rosiglitazone selection bias significant Simvastatin statistical subgroup analyses systematic reviews techniques tests therapeutic interventions treated treatment