In This Section
- About
- Background
- Why are fair tests of treatments needed?
- New – but is it better?
- Hoped-for effects that don’t materialize
- More is not necessarily better
- Earlier is not necessarily better
- Lessons from neuroblastoma screening
- Weighing benefits and harms
- Phenylketonuria screening: clearly beneficial
- Abdominal aortic aneurysm screening: proceed with care
- Breast cancer screening: well established but remains contentious
- Prostate cancer screening: clear harms with uncertain benefits
- Lung cancer screening: early but not early enough?
- Genetic tests: sometimes useful, often dodgy
- What screening aims to achieve and why evidence matters
- Is anyone normal?
- References (Section 4)
- Dealing with uncertainty about the effects of treatments
- What are fair tests of treatments?
- Fair tests of treatments
- Why are fair tests of treatments needed?
- Comparing like with like
- Treatments with dramatic effects
- Treatments with moderate but important effects
- Comparing patients given treatments today with apparently similar patients given other treatments in the past for the same disease
- Comparing apparently similar groups of patients who happen to have received different treatments in the same time period
- Unbiased, prospective allocation to different treatments
- Ways of using unbiased (random) allocation in treatment comparisons
- Following up everyone in treatment comparisons
- Dealing with departures from allocated treatments
- Helping people to stick to allocated treatments
- Fair measurement of treatment outcomes
- Generating and investigating hunches about unanticipated adverse effects of treatments
- References (Section 6)
- Taking account of the play of chance
- Assessing all the relevant, reliable evidence
- Fair tests of treatments
- What can we do to improve tests of treatments?
- Regulating tests of treatments: help or hindrance?
- Research – good, bad and unnecessary
- Getting the right research done is everybody’s business
- So what makes for better healthcare?
- What might the ideas in this website look like for you?
- Shared decision making: a consultation for a common condition
- Questions about translating research evidence into practice
- 1: Isn’t anything worth trying when a patient has a life-threatening condition?
- 2: Although patients might want to know if a treatment ‘works’, suppose they don’t want all the details?
- 3: Statistics are confusing – should patients really have to look at the numbers?
- 4: How can someone know that the research evidence applies to them?
- 5: Won’t genetic testing – and ‘personalized medicine’ – mean doctors can work out the specific treatment needed in every individual and make all this unnecessary?
- 6: If someone has a condition that is being studied in an ongoing clinical trial, how do they find out about this if their doctor doesn’t know about it?
- 7: What’s the best way of telling if the evidence (on the web or elsewhere) is reliable?
- 8: Are there reliable sources of information that can be recommended?
- 9: How should people avoid being ‘labelled’ with an ‘illness’ and getting unnecessary treatments?
- Where do we go from here?
- References (Section 12)
- Research for the right reasons: blueprint for a better future