*IMPORTANT: We have retired. Delfini tools/resources referenced in the book will not be available past 2023.*
"I am full of admiration for this terrific little book...which is written clearly, simply and appropriately for a starter audience. Those with more experience...can benefit too. I know of no other book that has succeeded so well in getting everything important covered so succinctly, which the authors have done brilliantly well!" Richard Lehman, MA, BM, BCh, Oxford, & Blogger, BMJ Journal Watch
The shocking truth is that most scientific research that informs most doctors' medical decisions is unreliable or is of uncertain reliability. And many doctors and other health care professionals do not realize this. Every day patients are harmed by unfortunate health care choices—and some of them die because of it. Too often this happens because of problems with the information provided to the patient—or its lack—where different information could have resulted in a very different choice—and a very different outcome.
The good news is that you only need to know a few, easy-to-understand statistics, and you need a few basic concepts to help you understand bias and chance.
Medical evidologists and clinical improvement experts, Sheri Ann Strite and Michael E. Stuart MD, provide you with easy-to-understand guidance.
In a few hours, you can learn basic critical appraisal skills to help you evaluate clinical trials and other medical research studies of therapeutic interventions.
Based on their popular simplified and tool-based approach, the authors show you how to evaluate the reliability and clinical usefulness of clinical trials. Written for physicians and other health care professionals, this book is written in easy-to-understand terms that even the layperson can understand and put to use.
What is Unique About This Book
Practical—information can be applied instantlyConcise—can be read in a few hours
Clear—key concepts are explained in easy-to-understand language
Complete enough—We give you the basics you need to evaluate most clinical trials of therapies. We don't bog you down with details you do not need to know. With rare exception, or unless you are a researcher, you don't need to know such concepts as the different observational study types, you don't need to understand power calculations, and you only need a few, easy-to-understand statistics—we give you simple explanations that you can even use in explaining results to patients.
You will learn that the primary key to understanding the reliability of studies is largely about study design, execution and study performance outcomes. You will learn—
—Experiments versus Observations: The quick and easy way to distinguish between experiments and observations—and why you need to know the difference.
—Assessing Selection Bias: 5 Essential QuestionsImportant considerations include who was studied, how were they selected for study, are there enough people, how were they assigned to their study groups, and are the groups balanced?
—Assessing Performance Bias: 2 Essential QuestionsWhat is being studied, and what is it being compared to? What else happened to study subjects in the course of the study?
—Assessing Measurement & Attrition Bias: 2 Essential QuestionsWhat information was collected, and how was it collected? What data are missing, and does missing data meaningfully distort the study results?
—Assessing Assessment Bias: 2 Essential QuestionsHow is the difference in outcomes between the groups evaluated? What are those differences and how are they expressed?
—Understanding Chance
—Easy Ways to Evaluate Results
—Safety
—Evaluating Authors' Conclusions
This book will help your patients better avoid what has happened to millions of patients—insufficient or misleading information leading to unfortunate choices that resulted in bad outcomes.
Delfini Group is a public service entrepreneurship founded to advance applied evidence- and value-based clinical quality improvements through practice, training and facilitation. Much of Delfini's work is dedicated to solving medical misinformation problems. Delfini has contributed to text books, advised government entities, worked with health care systems, payers and manufacturers and has trained thousands in evidence-based quality improvement.
Michael E. Stuart MD & Sheri Ann Strite are medical information scientists, evidologists and clinical improvement experts who combine academic and practical experience to train people how to evaluate medical research studies, conduct evidence reviews, help health care systems apply evidence- and value-based clinical quality improvement methods including special help for work groups such as clinical guideline development teams, pharmacy & therapeutics and medical technology assessment committees, clinical quality improvement teams and more. They also train physicians and others in communicating with patients.
Sheri Ann Strite, Co-founder, Principal & Managing Partner, initiated many Delfini health care improvement strategies, tools and training programs including the popular Delfini critical appraisal training program. Formerly she was Associate Director, Program Development, University of California, San Diego (UCSD) Family & Preventive Medicine, School of Medicine, where she taught faculty, physicians, residents, students and others. She was also a member of the UCSD Family Medicine Research Leaders and faculty for their Research Fellowship in the Department of Family & Preventive Medicine. Prior to UCSD, Ms. Strite worked in clinical improvement, education and research at Group Health Cooperative in Seattle, Washington, where she held various positions.
Michael E. Stuart MD, Co-founder, President & Medical Director, is a family physician and was appointed clinical faculty at the University of Washington in 1975. He is the former Director of the Department of Clinical Improvement and Education at Group Health Cooperative in Seattle, Washington, where he led development of more than 35 evidence-based clinical guidelines and other clinical improvements, chaired the Pharmacy & Therapeutics and Medical Technology Assessment Committees. His work has received praise from prominent health care leaders such as David Eddy MD, Don Berwick MD, Health Ministry of New Zealand and the US Navy.
