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This section of the website contains the hypertext of Testing Treatments.
These pages will give you a quick overview of what all the fuss is about:
- Why do we need fair tests of treatments?
- What are fair tests of treatments?
- What can be done to improve tests of treatments?
- How can YOU help to improve tests of treatments?
You can use the Book Sections menu on the right to jump directly to particular sub-sections. Once you enter a section, this menu will update to reflect your current location.
- Imogen Evans
- Hazel Thornton
- Iain Chalmers
- Paul Glasziou
Find out more about the authors.
You can listen to the audio version of the book using the control panel below.
As you browse the Book Sections on the website, you will find that each section has an Audio version embedded at the top.
- About the book
- 1 – New, but is it better?
- 2 – Hoped-for effects that don’t materialize
- 3 – More is not necessarily better
- 4 – Earlier is not necessarily better
- Lessons from neuroblastoma screening
- Weighing benefits and harms
- Phenylketonuria screening: clearly beneficial
- Abdominal aortic aneurysm screening: proceed with care
- Breast cancer screening: well established but remains contentious
- Prostate cancer screening: clear harms with uncertain benefits
- Lung cancer screening: early but not early enough?
- Genetic tests: sometimes useful, often dodgy
- What screening aims to achieve and why evidence matters
- Is anyone normal?
- References (Chapter 4)
- 5 – Dealing with uncertainty about the effects of treatments
- Dramatic treatment effects: rare and readily recognizable
- Laser treatment of portwine stains
- Imatinib for chronic myeloid leukaemia
- Mother’s kiss
- A new treatment for strawberry birthmarks
- Moderate treatments effects: usual and not so obvious
- When practitioners disagree
- Caffeine for breathing problems in premature babies
- Antibiotics in pre-term labour
- Breast cancer
- Addressing uncertainties about the effects of treatments
- Providing treatment as part of a fair test
- References (Chapter 5)
- 6 – Fair Tests of Treatments
- Why are fair tests of treatments needed?
- The beneficial effects of optimism and wishful thinking
- The need to go beyond impressions
- So what are fair tests?
- Comparing like with like
- Treatments with dramatic effects
- Treatments with moderate but important effects
- Comparing patients given treatments today with apparently similar patients given other treatments in the past for the same disease
- Comparing apparently similar groups of patients who happen to have received different treatments in the same time period
- Unbiased, prospective allocation to different treatments
- Ways of using unbiased (random) allocation in treatment comparisons
- Following up everyone in treatment comparisons
- Dealing with departures from allocated treatments
- Fair measurement of treatment outcomes
- Helping people to stick to allocated treatments
- Generating and investigating hunches about unanticipated adverse effects of treatments
- References (Chapter 6)
- 7 – Taking account of the play of chance
- 8 – Assessing all the relevant, reliable evidence
- Is one study ever enough?
- Systematic reviews of all the relevant, reliable evidence
- Reducing biases in systematic reviews
- Identifying all the relevant evidence for systematic reviews
- Reducing the play of chance in systematic reviews
- Recognizing vested interests and spin in systematic reviews
- What can happen if all the relevant, reliable evidence is not assessed?
- Avoidable harm to patients
- Avoidable harm to people participating in research
- Wasted resources in healthcare and research
- Reports of new research should begin and end with systematic reviews
- References (Chapter 8)
- 9 – Regulating tests of treatments: help or hindrance?
- 10 – Research – good, bad and unnecessary
- Good research
- Pre-eclampsia in pregnant women
- HIV infection in children
- Bad research
- Psychiatric disorders
- Epidural analgesia for women in labour
- Unnecessary research
- Respiratory distress in premature babies
- Aprotinin: effect on bleeding during and after surgery
- Distorted research priorities
- Questions that are important for patients
- Who decides what gets studied?
- References (Chapter 10)
- 11 – Getting the right research done is everybody’s business
- How can patients and the public help to improve research?
- Involving patients in research
- How patients can jeopardize fair tests of treatments
- Patients’ organizations: independent voices or not?
- Bridging the gap between patients and researchers
- Working collaboratively bodes well for the future
- References (Chapter 11)
- 12 – So what makes for better healthcare?
- What might the ideas in this website look like for you?
- Shared decision making: a consultation for a common condition
- Questions about translating research evidence into practice
- 1: Isn’t anything worth trying when a patient has a life-threatening condition?
- 2: Although patients might want to know if a treatment ‘works’, suppose they don’t want all the details?
- 3: Statistics are confusing – should patients really have to look at the numbers?
- 4: How can someone know that the research evidence applies to them?
- 5: Won’t genetic testing – and ‘personalized medicine’ – mean doctors can work out the specific treatment needed in every individual and make all this unnecessary?
- 6: If someone has a condition that is being studied in an ongoing clinical trial, how do they find out about this if their doctor doesn’t know about it?
- 7: What’s the best way of telling if the evidence (on the web or elsewhere) is reliable?
- 8: Are there reliable sources of information that can be recommended?
- 9: How should people avoid being ‘labelled’ with an ‘illness’ and getting unnecessary treatments?
- Where do we go from here?
- References (Chapter 12)
- 13 – Research for the right reasons: blueprint for a better future
GET-IT Jargon Buster
GET-IT provides plain language definitions of health research terms