The #1 guide to the principles and clinical applications of evidence-based medicine has just gotten better!

No other resource helps you to put key evidence-based medicine protocols into daily clinical practice better than Users' Guides to the Medical Literature.

An instant classic in its first edition, this detailed, yet highly readable reference demystifies the statistical, analytical, and clinical principles of evidence-based medicine, giving you a hands-on, practical resource that no other text can match.

Here, you'll learn how to distinguish solid medical evidence from poor medical evidence, devise the best search strategies for each clinical question, critically appraise the medical literature, and optimally tailor evidence-based medicine for each patient. The new second edition of this landmark resource is now completely revised and refreshed throughout, with expanded coverage of both basic and advanced issues in using evidence-based medicine in clinical practice.

FEATURES

• Completely revised and updated to reflect the enormous expansion in medical research and evidence-based resources since the first edition
• Innovative organization guides you from the fundamentals of using the medical literature to the more advanced strategies and skills for use in every day patient care situations
• Abundant and current real-world examples drawn from the medical literature are woven throughout, and include important related principles and pitfalls in using medical literature in patient care decisions
• Practical focus on the key issues in evidence-based practice: What are the results? Are the results valid? How to I apply to results to the care of my patients?
• Edited by over 60 internationally recognized editors and contributors from the U.S., Canada, South America, Europe, and Asia-the best of the best in the discipline
• NEW, Current, authoritative content covering how to: Avoid being misled by biased presentations of research findings; Interpret the significance of clinical trials that are discontinued early; Influence clinician behavior to improve patient care; Apply key strategies for teaching evidence-based medicine; And more

Also look for JAMAevidence.com, a new interactive database for the best practice of evidence based medicine.

Contributors     xi
Foreword     xvii
Preface     xxi
The Foundations
How to Use the Medical Literature-and This Book-to Improve Your Patient Care     3
The Philosophy of Evidence-Based Medicine     9
What Is the Question?     17
Finding the Evidence     29
Why Study Results Mislead: Bias and Random Error     59
Therapy
Therapy (Randomized Trials)     67
Does Treatment Lower Risk? Understanding the Results     87
Confidence Intervals     99
Advanced Topics in the Validity of Therapy Trials
An Illustration of Bias and Random Error     109
Surprising Results of Randomized Trials     113
Randomized Trials Stopped Early for Benefit     153
The Principle of Intention to Treat     167
N-of-1 Randomized Controlled Trials     179
Clinical Decision Support Systems     193
Advanced Topics in the Results of Therapy Trials
Hypothesis Testing     209
Understanding the Results: More About Odds Ratios     221
What Determines the Width of the Confidence Interval?     231
Composite Endpoints     237
Measuring Patients' Experience     249
Advanced Topics in Applying the Results of TherapyTrials
Applying Results to Individual Patients     273
Example Numbers Needed to Treat     291
Dealing With Misleading Presentations of Clinical Trial Results     301
Surrogate Outcomes     317
Qualitative Research     341
Harm (Observational Studies)
Harm (Observational Studies)     363
Advanced Topics in Harm: Correlation and Regression     383
Diagnosis
The Process of Diagnosis     399
Differential Diagnosis     407
Diagnostic Tests     419
Advanced Topics in Diagnosis
Spectrum Bias     439
Examples of Likelihood Ratios     449
Measuring Agreement Beyond Chance     481
Clinical Prediction Rules     491
Prognosis
Prognosis     509
Summarizing the Evidence
Summarizing the Evidence     523
Advanced Topics in Systematic Reviews
Reporting Bias     543
Fixed-Effects and Random-Effects Models     555
Making Sense of Variability in Study Results     563
When to Believe a Subgroup Analysis     571
Moving From Evidence to Action
How to Use a Patient Management Recommendation     597
Advanced Topics in Moving From Evidence to Action
Economic Analysis     619
Decision Making and the Patient     643
Moving From Evidence to Action: Recommendations About Screening     663
Grading Recommendations     679
Drug Class Effects     703
Parallel but Separate Goals: Evidence-Based Practitioners and Evidence-Based Care     717
Changing Behavior to Apply Best Evidence in Practice     721
Teachers' Guides to the Users' Guides     743
Glossary     769
Index     809