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How do we know whether a particular treatment really works? How
reliable is the evidence? And how do we ensure that research into
medical treatments best meets the needs of patients? These are just
a few of the questions addressed in a lively and informative way in
Testing Treatments. Brimming with vivid examples, Testing
Treatments will inspire both patients and professionals. Building
on the success of the first edition, Testing Treatments has now
been extensively revised and updated. The Second Edition includes a
thought-provoking chapter on screening, explaining why early
diagnosis is not always better. Other new chapters explore how
over-regulation of research can work against the best interests of
patients, and how robust evidence from research can be drawn
together to shape the practice of healthcare in ways that allow
treatment decisions to be reached jointly by patients and
clinicians. Testing Treatments urges everyone to get involved in
improving current research and future treatment, and outlines
practical steps that patients and doctors can take together.
Decision making in health care involves consideration of a complex
set of diagnostic, therapeutic and prognostic uncertainties.
Medical therapies have side effects, surgical interventions may
lead to complications, and diagnostic tests can produce misleading
results. Furthermore, patient values and service costs must be
considered. Decisions in clinical and health policy require careful
weighing of risks and benefits and are commonly a trade-off of
competing objectives: maximizing quality of life vs maximizing life
expectancy vs minimizing the resources required. This text takes a
proactive, systematic and rational approach to medical decision
making. It covers decision trees, Bayesian revision, receiver
operating characteristic curves, and cost-effectiveness analysis;
as well as advanced topics such as Markov models, microsimulation,
probabilistic sensitivity analysis and value of information
analysis. It provides an essential resource for trainees and
researchers involved in medical decision modelling, evidence-based
medicine, clinical epidemiology, comparative effectiveness, public
health, health economics, and health technology assessment.
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