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Informing Clinical Practice in Nephrology - The Role of RCTs (Hardcover)
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Informing Clinical Practice in Nephrology - The Role of RCTs (Hardcover)
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Historically, clinical decisions in renal medicine have been
challenged by the scarce availability of robust supportive
evidence. Not only are the number of randomized controlled trials
(RCTs) in Nephrology the third lowest amongst the medical
specialties but in many instances the trials themselves are of poor
quality. In addition, practice has been further influenced by
extrapolation from the outcomes of general population clinical
trials which exclude renal patients. The difference between the
ideal trial participant and real complex cases encountered in daily
practice is well recognized and further compounded in renal
patients with complex pathophysiology - this ultimately makes
decision making in this subset of patients a real challenge.
Recently, there has been a growing interest in conducting well
designed RCTs in different areas of renal medicine. However, though
clinical guidelines are helpful in providing the clinicians with a
frame of best available evidence for a clinical condition, it
denies the unique nature of each individual patient. This book
offers a thorough and critical appraisal and evaluation of the key
published clinical trials that have shaped current practice in
nephrology, dialysis and transplantation. It will help the
practicing physician close the gap between the inflexible and
generalized nature of clinical guidelines and the day-to-day
clinical decision-making for individual patients. It will provide
the clinician with the tools required to investigate and extract
the appropriate guidance to apply to individual cases in daily
practice. Moreover, it will help improve the ability of junior
colleagues to appraise available evidence in a systematic way when
there is lack of local guidelines or when the guidelines are
difficult to apply due to logistic constraints or barriers. Lastly,
this book will serve as a reference for key clinical trials in
different areas of renal medicine together with literature and
authors views of these trials and their impact on changing
practice.
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