Rational Diagnosis and Treatment: Evidence-Based Clinical Decision-Making

Table Of Contents

Preface vii
Introduction 1 (4)
The Foundation of Clinical Decisions
The clinical decision process
Clinical data
Scales of measurement
Taking the history
The physical examination
Paraclinical findings
Global assessments
The Reliability and Relevance of Clinical Data
Clinical data on an interval scale
Clinical data on an ordinal scale
Clinical data on a binary scale
The statistical concept of normality
The concept of disease
Interpretation and relevance
The Disease Classification
The historical perspective
The theoretical perspective
The practical perspective
Diagnosis
The diagnostic universe
Diagnosis of diseases with an accessible defining criterion
Diagnosis of diseases with a concealed defining criterion
Syndrome diagnosis
Three patients
Diagnosis in practice
Uncontrolled Experience
Uncontrolled experience in a pre-scientific era
The numerical method
The era of laboratory research
The spontaneous course of the disease
Imprecision of clinical data and regression towards the mean
Run of luck
Bias
The placebo effect
The need for controlled experience
Alternative medicine: scientific and pseudoscientific thinking
The Randomized Clinical Trial
Selection of patients
Randomization
Choice of treatment in the control group
Principles of blinding
Cross-over trials
The choice of outcome measures
The statistical analysis
Meta-analysis
From trials to clinical practice
Medicine and the Humanities
The four components of clinical reasoning
The empathic-hermeneutic component
The ethical component
Clinical research ethics
Critical Reading of Medical Journals
Logical analysis of medical papers
Descriptive statistics
Estimation
Testing hypotheses
Sample size calculations
Dr N and Dr R
Statistical tests
Correlation analysis
Life table analysis
References
Index