How to Read a Paper: The Basics of Evidence-Based Medicine
Read How to Read a Paper: The Basics of Evidence-Based Medicine Online
Authors: Trisha Greenhalgh
Table of Contents
Foreword to the first edition by Professor Sir David Weatherall
Preface to the first edition: do you need to read this book?
Chapter 1: Why read papers at all?
Does ‘evidence-based medicine’ simply mean ‘reading papers in medical journals’?
Why do people sometimes groan when you mention evidence-based medicine?
Before you start: formulate the problem
References
Chapter 2: Searching the literature
What are you looking for?
Levels upon levels of evidence
Synthesised sources: systems, summaries and syntheses
Pre-appraised sources: synopses of systematic reviews and primary studies
Specialised resources
Primary studies—tackling the jungle
One-stop shopping: federated search engines
Asking for help and asking around
Online tutorials for effective searching
References
Chapter 3: Getting your bearings: what is this paper about?
The science of ‘trashing’ papers
Three preliminary questions to get your bearings
Randomised controlled trials
Cohort studies
Case–control studies
Cross-sectional surveys
Case reports
The traditional hierarchy of evidence
A note on ethical considerations
References
Chapter 4: Assessing methodological quality
Was the study original?
Whom is the study about?
Was the design of the study sensible?
Was systematic bias avoided or minimised?
Was assessment ‘blind’?
Were preliminary statistical questions addressed?
Summing up
References
Chapter 5: Statistics for the non-statistician
How can non-statisticians evaluate statistical tests?
Have the authors set the scene correctly?
Paired data, tails and outliers
Correlation, regression and causation
Probability and confidence
The bottom line
Summary
References
Chapter 6: Papers that report trials of drug treatments and other simple interventions
‘Evidence’ and marketing
Making decisions about therapy
Surrogate endpoints
What information to expect in a paper describing a randomised controlled trial: the CONSORT statement
Getting worthwhile evidence out of a pharmaceutical representative
References
Chapter 7: Papers that report trials of complex interventions
Complex interventions
Ten questions to ask about a paper describing a complex intervention
References
Chapter 8: Papers that report diagnostic or screening tests
Ten men in the dock
Validating diagnostic tests against a gold standard
Ten questions to ask about a paper that claims to validate a diagnostic or screening test
Likelihood ratios
Clinical prediction rules
References
Chapter 9: Papers that summarise other papers (systematic reviews and meta-analyses)
When is a review systematic?
Evaluating systematic reviews
Meta-analysis for the non-statistician
Explaining heterogeneity
New approaches to systematic review
References
Chapter 10: Papers that tell you what to do (guidelines)
The great guidelines debate
How can we help ensure that evidence-based guidelines are followed?
Ten questions to ask about a clinical guideline
References
Chapter 11: Papers that tell you what things cost (economic analyses)
What is economic analysis?
Measuring costs and benefits of health interventions
References
Chapter 12: Papers that go beyond numbers (qualitative research)
What is qualitative research?
Evaluating papers that describe qualitative research
References
Chapter 13: Papers that report questionnaire research
The rise and rise of questionnaire research
Ten questions to ask about a paper describing a questionnaire study
References
Chapter 14: Papers that report quality improvement case studies
What are quality improvement studies—and how should we research them?
Ten questions to ask about a paper describing a quality improvement initiative
References
Chapter 15: Getting evidence into practice
Why are health professionals slow to adopt evidence-based practice?
How much avoidable suffering is caused by failing to implement evidence?
How can we influence health professionals' behaviour to promote evidence-based practice?
What does an ‘evidence-based organisation’ look like?
How can we help organisations develop the appropriate structures, systems and values to support evidence-based practice?
References
Chapter 16: Applying evidence with patients
The patient perspective
PROMs
Shared decision-making
Option grids
n
of 1 trials and other individualised approaches
References
Chapter 17: Criticisms of evidence-based medicine
What's wrong with EBM when it's done badly?
What's wrong with EBM when it's done well?
Why is ‘evidence-based policymaking’ so hard to achieve?
References
Appendix 1: Checklists for finding, appraising and implementing evidence
Is my practice evidence-based?—a context-sensitive checklist for individual clinical encounters (see Chapter 1)
Checklist for searching (see Chapter 2)
Checklist to determine what a paper is about (see Chapter 3)
Checklist for the methods section of a paper (see Chapter 4)
Checklist for the statistical aspects of a paper (see Chapter 5)
Checklist for material provided by a pharmaceutical company representative (see Chapter 6)
Checklist for a paper describing a study of a complex intervention (see Chapter 7)
Checklist for a paper that claims to validate a diagnostic or screening test (see Chapter 8)
Checklist for a systematic review or meta-analysis (see Chapter 9)
Checklist for a set of clinical guidelines (see Chapter 10)
Checklist for an economic analysis (see Chapter 11)
Checklist for a qualitative research paper (see Chapter 12)
Checklist for a paper describing questionnaire research (see Chapter 13)
Checklist for a paper describing a quality improvement study (see Chapter 14)
Checklist for health care organisations working towards an evidence-based culture for clinical and purchasing decisions (see Chapter 15)
Appendix 2: Assessing the effects of an intervention
Acknowledgement
This edition first published 2014, © 2010, 2014 by John Wiley & Sons Ltd
BMJ Books is an imprint of BMJ Publishing Group Limited, used under licence by John Wiley & Sons.