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Clinical Decision Support

Users' Guides to the Medical Literature

Users' Guides to the Medical Literature:

A Manual for Evidence-Based Clinical Practice, 2nd Edition

Gordon Guyatt, Drummond Rennie, Maureen O. Meade, and Deborah J. Cook

Contributors | Foreword | Preface | Dedication | Copyright

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A The Foundations

1 How to Use the Medical Literature—and This Book—to Improve Your Patient Care

2 The Philosophy of Evidence-Based Medicine

3 What Is the Question?

4 Finding the Evidence

5 Why Study Results Mislead: Bias and Random Error

B Therapy

6 Therapy (Randomized Trials)

7 Does Treatment Lower Risk? Understanding the Results

8 Confidence Intervals

9 Advanced Topics in the Validity of Therapy Trials

9.1 An Illustration of Bias and Random Error

9.2 Surprising Results of Randomized Trials

9.3 Randomized Trials Stopped Early for Benefit

9.4 The Principle of Intention to Treat

9.5 N-of-1 Randomized Controlled Trials

9.6 Clinical Decision Support Systems

10 Advanced Topics in the Results of Therapy Trials

10.1 Hypothesis Testing

10.2 Understanding the Results: More About Odds Ratios

10.3 What Determines the Width of the Confidence Interval?

10.4 Composite Endpoints

10.5 Measuring Patients' Experience

11 Advanced Topics in Applying the Results of Therapy Trials

11.1 Applying Results to Individual Patients

11.2 Example Numbers Needed to Treat

11.3 Dealing With Misleading Presentations of Clinical Trial Results

11.4 Surrogate Outcomes

11.5 Qualitative Research

C Harm

12 Harm (Observational Studies)

13 Advanced Topics in Harm: Correlations and Regression

D Diagnosis

14 The Process of Diagnosis

15 Differential Diagnosis

16 Diagnostic Tests

17 Advanced Topics in Diagnosis

17.1 Spectrum Bias

17.2 Examples of Likelihood Ratios

17.3 Measuring Agreement Beyond Chance

17.4 Clinical Prediction Rules

E Prognosis

18 Prognosis

e18.1 Online Only: How to Use an Article About Genetic Association

F Summarizing the Evidence

19 Summarizing the Evidence

20 Advanced Topics in Systematic Reviews

20.1 Reporting Bias

20.2 Fixed-Effects and Random-Effects Models

20.3 Making Sense of Variability in Study Results

20.4 When to Believe a Subgroup Analysis

G Moving from Evidence to Action

21 How to Use a Patient Management Recommendation

22 Advanced Topics in Moving From Evidence to Action

22.1 Economic Analysis

22.2 Decision Making and the Patient

22.3 Moving From Evidence to Action: Recommendations About Screening

22.4 Grading Recommendations

22.5 Drug Class Effects

22.6 Parallel but Separate Goals: Evidence-Based Practitioners and Evidence-Based Care

22.7 Changing Behavior to Apply Best Evidence in Practice

22.8 Teachers' Guides to the Users' Guides

e23 Online Only: How to Use an Article About Quality Improvement

Quick Reference Online diagnostic and treatment information from the print edition pocket cards

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