By Janet Peacock
To perform evidence-based drugs, medical professionals have to know how learn is performed and have the capacity to significantly appraise learn facts. a valid realizing of clinical records is key for the proper overview of scientific examine and the perfect implementation of findings in scientific perform.
Written in an simply available variety, the Oxford instruction manual of scientific Statistics offers medical professionals and scientific scholars with a concise and thorough account of this usually tough topic. It promotes realizing and interpretation of statistical equipment throughout quite a lot of issues, from research layout and pattern measurement issues, via t- and chi-squared assessments, to advanced multifactor analyses, utilizing examples from released examine. References for extra analyzing are given for additional information on particular topics.
Helping readers to behavior their very own examine or significantly appraise other's paintings, this quantity offers all of the details readers have to comprehend and interpret clinical statistics.
Read or Download Oxford handbook of medical statistics PDF
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Declaration of Helsinki, item 24) Informed consent • This requires giving patients detailed description of the study aims, what participation is required, and any risks they may be exposed to • Consent must be voluntary • Consent is confirmed in writing and a cooling off period is provided to allow subjects to change their minds • Consent must be obtained for all patients recruited to an RCT • Giving or withholding consent must not affect patient treatment or access to services • For questionnaire surveys, consent is often implicit if the subject returns the questionnaire where it is clear in the accompanying information that participation is voluntary • Consent may not be required if the study involves anonymised analyses of patient data only When consent may be withheld In some situations, obtaining patient consent to a study may be problematic.
Routine blood tests were normal and a 72-hour fast produced no symptoms of hypoglycaemia (low blood sugar). Further investigations led to the discovery of an insulin-secreting tumour in the body of the pancreas. The tumour was producing excess insulin in response to glucose, therefore causing glucose-induced hypoglycaemia. 2 The paper reported the symptoms, complications, and outcome in 87 consecutive meningitis patients seen in a particular neurology department. The authors stated that their analysis can help doctors identify prognostic factors in patients, and can guide the design of future research studies.
19 20 CHAPTER 1 Research design Superiority and equivalence trials Superiority trials • Seek to establish that one treatment is better than another • When the trial is designed the sample size is set so that there is high statistical power to detect a clinically meaningful difference between the two treatments • For such a trial a statistically significant result is interpreted as showing that one treatment is more effective than the other Equivalence trials • Seek to test if a new treatment is similar in effectiveness to an existing treatment • Appropriate if the new treatment has certain benefits such as fewer side effects, being easier to use, or being cheaper • Trial is designed to be able to demonstrate that, within given acceptable limits, the two treatments are equally effective • Equivalence is a pre-set maximum difference between treatments such that, if the observed difference is less than this, the two treatments are regarded as equivalent • The limits of equivalence need to be set to be appropriate clinically • The tighter the limits of equivalence are set, the larger the sample size that will be required • If the condition under investigation is serious then tighter limits for equivalence are likely to be needed than if the condition is less serious • The calculated sample size tends to be bigger for equivalence trials than superiority trials Non-inferiority trials • Special case of the equivalence trial where the researchers only want to establish if a new treatment is no worse than an existing treatment • In this situation the analysis is by nature one-sided (b Tests of statistical significance, p.
