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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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