Read e-book How to Read a Paper: The Basics of Evidence-Based Medicine (5th Edition)

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How I read a paper!

Liessa , Oct 19, Inara , hinterland , Andy and 2 others like this. I read the abstract, then the conclusion, then decide how much of the rest I want to read. Graphs and tables are useful. Trish , Oct 19, Inara , Liessa and Andy like this.

Messages: Likes Received: 6, Reading the article in the OP, it becomes clearer to me why so many scientists have fallen for the PACE et al nonsense JemPD , Oct 19, Samuel , Skycloud , Inara and 2 others like this. Andy , Oct 19, Indigophoton and Trish like this. The link is to the second edition which is copyright It's a free page PDF download. Several later editions are available on Amazon for eye-watering prices. The latest is the 5th Edition. Have I read it?

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Book review

I started it but didn't have the stamina to get very far, and now I've forgotten what I read. The final 3 chapters really cover the challenges of implementing EBM from a policy perspective, as well as discussing and affirming some of the major critiques of EBM. Introductory Chapters The first chapters of How to Read a Paper are about setting the framework for engaging the literature critically and methodically.

After establishing the importance of comprehensive, conscious literature reviews, the author uses the next several chapters to discuss how to frame research questions, how best to initiate a search, and key methodological and statistical issues to review to determine if the science behind the paper—in the context of other similar papers—actually supports the conclusions that are briefly written in the abstract. These checklists are used throughout the rest of the text as well and are nicely compiled in the appendices of the book.

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Specific Types of Papers The next 9 chapters train readers in an evidence-based approach to assessing different types of clinically relevant papers: randomized controlled trials RCTs of simple and complex interventions, diagnostic testing, reviews and meta-analyses, qualitative research, economic analyses, and practice guidelines.

Given the realities of naturopathic medicine—and the oft-cited concerns about the difficulty of creating quality holistic health research—chapters 6 and 7 should not be glossed over. Greenhalgh uses as her example a clinical trial from her own experience in which using yoga in the treatment of diabetes was tested.

When the data were finally analyzed, however, her team was disheartened to learn that there had been no effect on the health status of the individuals with diabetes. The easy interpretation?

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Yoga has no effect on diabetes. The nuanced interpretation? Many of the participants failed to go to all of the sessions, and almost none of them did home exercises. From there, her research team did not proceed to a full-scale clinical trial but instead had to reconsider components of the trial and redesign a new pilot trial.

How to Read a Paper: The Basics of Evidence-Based Medicine by Trisha Greenhalgh

Greenhalgh uses this trial to illustrate several key concepts in reviewing the literature on complex interventions: Was preliminary research done? Did the outcomes from a pilot study support the development of a larger study?

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If the study was negative, was the problem really with the intervention or was it in the implementation of the intervention? Chapters on meta-analyses and guidelines are helpful to consider after having read through the basic clinical trial chapters and include discussion of the strengths and weaknesses of these larger aggregations of data.


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Chapters on economic analysis, qualitative research nonnumeric, often psychosocial in nature , questionnaires, and quality-improvement are probably of limited interest to most general clinicians, though even here there are areas of interest naturopathic physicians might be especially interested in the chapter on qualitative research, which may explore how patients get engaged in their own healthcare. Culture and Critique of Evidence-based Medicine The final chapters in this book review the difficulties with institutional implementation of EBM, using and discussing evidence with patients taking into account their own preferences , and ends with a critique of the entire enterprise of EBM.


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We naturopathic physicians pride ourselves on developing individualized, holistic treatment plans.