Technical Rational Diagnosis and Treatment: Evidence-Based Clinical Decision-Making (0632031972)

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Rational Diagnosis and Treatment: Evidence-Based Clinical Decision-Making

By Henrik R. Wulff, Peter C, M.D. Gotzche

Table Of Contents

Preface vii

Introduction 1 (4)

The Foundation of Clinical Decisions

The clinical decision process

Clinical data

Scales of measurement

Taking the history

The physical examination

Paraclinical findings

Global assessments

The Reliability and Relevance of Clinical Data

Clinical data on an interval scale

Clinical data on an ordinal scale

Clinical data on a binary scale

The statistical concept of normality

The concept of disease

Interpretation and relevance

The Disease Classification

The historical perspective

The theoretical perspective

The practical perspective

Diagnosis

The diagnostic universe

Diagnosis of diseases with an accessible defining criterion

Diagnosis of diseases with a concealed defining criterion

Syndrome diagnosis

Three patients

Diagnosis in practice

Uncontrolled Experience

Uncontrolled experience in a pre-scientific era

The numerical method

The era of laboratory research

The spontaneous course of the disease

Imprecision of clinical data and regression towards the mean

Run of luck

Bias

The placebo effect

The need for controlled experience

Alternative medicine: scientific and pseudoscientific thinking

The Randomized Clinical Trial

Selection of patients

Randomization

Choice of treatment in the control group

Principles of blinding

Cross-over trials

The choice of outcome measures

The statistical analysis

Meta-analysis

From trials to clinical practice

Medicine and the Humanities

The four components of clinical reasoning

The empathic-hermeneutic component

The ethical component

Clinical research ethics

Critical Reading of Medical Journals

Logical analysis of medical papers

Descriptive statistics

Estimation

Testing hypotheses

Sample size calculations

Dr N and Dr R

Statistical tests

Correlation analysis

Life table analysis

References

Index

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