Livres : « Clinical observational study »

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Body and mind in old age and decay : Problems in dementia senilis, a study in literature, followed by longitudinal clinical observations. Assen, Netherlands : Van Gorcum, 1986.

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Prout, Jeremy, Tanya Jones et Daniel Martin. Statistical basis of clinical trials. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0009.

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This chapter summarizes some aspects of study design and statistical analysis to allow the anaesthetist to appraise research. Types of observational study are described and aspects of interventional studies such as sample size calculation and power are explained. Research governance, phases of drug trials and levels of evidence are described. A section on statistical analysis includes expression of proportion for binary data (odds ratio, number needed to treat) and use of probability and confidence intervals to measure statistical significance.

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Ray, Sumantra (Shumone), Sue Fitzpatrick, Rajna Golubic, Susan Fisher et Sarah Gibbings, dir. Navigating research methods : quantitative and clinical/epidemiological methods. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199608478.003.0003.

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This chapter focuses on various types of study design used in clinical and healthcare research with an emphasis on observational studies whilst randomised controlled trials are explained in Chapter 15. Within observational studies, the distinction between descriptive and analytical studies is made and different sources of error in epidemiological studies are reviewed. Main features, advantages and disadvantages of analytical observational studies are described for the following designs: ecological studies, cohort studies, case-control studies and cross-sectional studies. A brief overview of experimental studies is also given. Measures of disease occurrence (prevalence, cumulative incidence, incidence rate) as well as effect measures (1.difference measures, ie. attributable risk, and 2. ratio measures, i.e. relative risk, odds ratio, relative risk reduction, attributable fraction) are reviewed. The chapter also presents major characteristics of meta-analysis.

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Alper, Joe, Claudia Grossmann, Roundtable on Value and Science-Driven Health Care, Institute of Medicine et A Learning Health System Activity. Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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Alper, Joe, Claudia Grossmann, Roundtable on Value and Science-Driven Health Care, Institute of Medicine et A Learning Health System Activity. Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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Alper, Joe, Claudia Grossmann, Roundtable on Value and Science-Driven Health Care, Institute of Medicine et A Learning Health System Activity. Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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8

Gray, Nathan A., et Thomas W. LeBlanc. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) (DRAFT). Sous la direction de Nathan A. Gray et Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0030.

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This chapter provides an overview and commentary on the SUPPORT trial main report, which began in 1989 and was published in 1995 and studied quality of care and communication in serious illness. It describes both the observational and interventional phases of this study, reviewing background and potential reasons for its negative findings. The chapter includes concise commentary on the study design and a brief review of relevant subsequent studies. Additionally, a short clinical case is included that highlights the impact of this study’s findings for similar interventions at the end-of-life and summarizes this large trial’s importance in forming a foundation for future study.

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Dahm, Philipp, dir. 50 Studies Every Urologist Should Know. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190655341.001.0001.

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This book describes the most influential studies that have shaped today’s clinical practice of urology. Its scope spans the spectrum of clinical urology, including genitourinary oncology (prostate, renal, bladder, and testis cancer), stone disease, benign prostatic hyperplasia, erectile dysfunction, and female urology. Most included studies are landmark randomized controlled trials related to questions of therapy, but the selection also includes prospective observational cohort studies as well as some case series that have resulted in paradigm-shifting changes in patient management. Each individual study is succinctly presented using a standardized format that focuses on the most important aspects relating to its design and main findings. This is followed by a summary of relevant, closely related studies as well as a brief critique of each study’s limitations. The evidence-based format of this book is further underscored by the frequent reference to relevant clinical practice guidelines. Each chapter closes with a clinical scenario that presents a management question for which an expert clinician proposes an answer based on the current best evidence.

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Arthur, Joseph. Palliative Sedation Therapy and Survival (DRAFT). Sous la direction de Nathan A. Gray et Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0045.

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Patients with advanced illness sometimes experience severe and debilitating physical and psychological symptoms at the end of life that may be refractory to all kinds of conventional treatments available for symptom relief. In such situations, palliative sedation therapy (PST) may be indicated. However, its utilization has been subject to debate. One viewpoint is that PST may hasten death. However, some studies have indicated otherwise. This chapter discusses a multicenter, prospective, observational, nonrandomized population-based study that compared the overall survival of a cohort of terminally ill patients who received PST with a similar group of patients who did not. The study showed that PST does not shorten life when used to relieve refractory symptoms. The chapter also presents a clinical case scenario to illustrate who should receive PST.

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Farrar, John T. Understanding clinical trials in palliative care research. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0193.

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Advances in basic science, translational, and clinical research have led to rapid improvements in our understanding of many disease processes. The randomized clinical trial (RCT) has played an important role in validating the benefits and harms of therapies thought to be potentially useful based on scientific theory or clinical observation, and has become the ‘gold standard’ for the demonstration of efficacy. As in all clinical study designs, the RCT has strengths and weaknesses that must be understood to appropriately interpret the study results. While randomization of the intended study population is the primary strength of such trials, choice of the study population, control condition, outcome measures, analysis procedure, and procedures for blinding the study participants can all affect the results. Understanding the requirements of a valid RCT and what can potentially go wrong will improve the conduct of palliative care research and the usefulness of published information in the care of patients.

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Elwood, Mark. Critical appraisal of a randomized clinical trial. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682898.003.0012.

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This chapter presents a randomised trial carried out in primary care in the UK, assessing the use of an antibiotic, chloramphenicol, for acute eye infections (conjunctivitis) in children. This study shows the challenges of conducting a high quality randomised trial in primary care, including issues of the appropriate assessment of outcome. The critical assessment follows the scheme set out in chapter 10: describing the study, assessing the non-causal explanations of observation bias, confounding, and chance variation; assessing time relationships, strength, dose-response, consistency and specificity, and applying the results to the eligible, source, and target populations; and then comparing the results with evidence from other studies, considering consistency and specificity, biological mechanisms, and coherence with the distribution of exposures and outcomes. The chapter gives a summary and table of the critical assessment and its conclusions; and comments on the impact of the study and research carried out since.

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Elwood, Mark. Critical Appraisal of Epidemiological Studies and Clinical Trials. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682898.001.0001.

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This book presents a system of critical appraisal applicable to clinical, epidemiological and public health studies and to many other fields. It assumes no prior knowledge. The methods are relevant to students, practitioners and policymakers. The book shows how to assess if the results of one study or of many studies show a causal effect. The book discusses study designs: randomised and non-randomised trials, cohort studies, case-control studies, and surveys, showing the presentation of results including person-time and survival analysis, and issues in the selection of subjects. The system shows how to describe a study, how to detect and assess selection biases, observation bias, confounding, and chance variation, and how to assess internal validity and external validity (generalisability). Statistical methods are presented assuming no previous knowledge, and showing applications to each study design. Positive features of causation including strength, dose-response, and consistency are discussed. The book shows how to do systematic reviews and meta-analyses, and discusses publication bias. Systems of assessing all evidence are shown, leading to a general method of critical appraisal based on 20 key questions in five groups, which can be applied to any type of study or any topic. Six chapters show the application of this method to randomised trials, prospective and retrospective cohort studies, and case-control studies. An appendix summarises key statistical methods, each with a worked example. Each main chapter has self-test questions, with answers provided.

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Kwon, Rachel J. Sentinel Lymph Node Biopsy versus Nodal Observation in Melanoma. Sous la direction de Patrick Borgen et Miguel A. Burch. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199384075.003.0025.

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This chapter provides a summary of a landmark study in surgical oncology. In patients with melanoma who undergo wide excision, does sentinel lymph node biopsy improve survival versus nodal observation (a “wait-and-watch” approach)? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case on sentinel lymph node biopsy versus nodal observation in melanoma.

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Clinicals Panic Astronomy Observation Book. Astronomy Observation Book Womens Nurse Eat Sleep Clinicals Panic Study Care Plans Repeat Good : Clinicals Panic Gifts for Girls : A Night Sky Observations Journal for Recording and Sketching Your Astronomical Observations, Astronomy Log Book Night Sky Obse. Independently Published, 2022.

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16

Laureno, Robert. Causation. Sous la direction de Robert Laureno. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190607166.003.0011.

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This chapter on “Causation” examines the determination of the causes of neurologic disease. Considered are Koch-Henle postuates and Bradford Hill criteria. When we talk about “cause,” we make a distinction between necessary and sufficient causes, as well as those causes of disease that are neither necessary nor sufficient, that contribute to the development of a disease but cannot by themselves cause the disease. Probabilistic causes show their effects in combination with other probabilistic causes, known and unknown. In the absence of experimental evidence for cause, we rely on observational information. Observational study may be prospective or retrospective (case-control study). The criteria for medicolegal causation in the courtroom and in the clinic differ, and the neurologist asked to determine cause in a court of law must rely on experience, good judgment, and common sense.

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Robins, Eli. The Final Months. Oxford University Press, 2017. http://dx.doi.org/10.1093/med-psych/9780195029116.001.0001.

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During a one-year period in the city of St Louis and surrounding counties, authorities determined that 134 of all deaths registered were suicides. This title is the report of a clinical study that attempts to determine the antecedents of those suicides, using information and observations contributed by the victims’ close associates. Based on a statistical computation of the information collected, the researchers were able to answer a number of previously open questions about suicide. This title includes a set of fully detailed case histories. Presented without interpretation, the allow readers to judge for themselves the clinical development of illness and the validity of diagnoses. In addition, a ‘score card’ for each case illustrates the study team’s step-by-step diagnostic procedure. Of particular interest to mental health workers will be a discussion of predictors of suicide and the process by which diagnoses were assigned.

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Elwood, Mark. The diagnosis of causation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682898.003.0010.

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This chapter brings the book together, showing the overall scheme of assessment of causation for one study or in many studies, based on 20 questions in five sections. The scheme includes describing the key features of the study; then assessing observation bias, confounding, and chance variation. The chapter presents the consideration of the positive features of causation: the Bradford Hill guidelines of time relationship, strength, dose-response, consistency, and specificity, leading to an assessment of internal validity. External validity (generalisability) relates to the eligible, source, and target populations. Comparisons with other studies assess consistency and specificity further, but also plausibility and coherence, including analogy and experimental evidence. The chapter shows the overall decision process. Applications to non-causal associations, other types of study, and in designing a study are discussed. In part two, the chapter shows applications of causal reasoning to clinical care and health policy, including hierarchies of evidence, methods used by important groups, and the GRADE system.

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Dunson, David. Flexible Bayes regression of epidemiologic data. Sous la direction de Anthony O'Hagan et Mike West. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780198703174.013.1.

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This article focuses on flexible Bayes regression of epidemiologic data involving pregnancy outcomes. It first provides an overview of finite mixture models and nonparametric Bayes methods before discussing some of the possibilities focusing on gestational age at delivery, DDE and age data from the Longnecker et al. (2001) study. More specifically, it examines how risk of premature delivery is impacted by maternal exposure to the pesticide DDT. The results showcase the use of Bayesian analysis in epidemiological studies that collect continuous health outcomes data, and in which the scientific and clinical interest typically focuses on the relationships between exposures and risks of an abnormal response, corresponding to an observation in the tails of the distribution. The article also highlights the limitations of current standard approaches that can be overcome by means of Bayesian analysis using density regression, mixtures and nonparametric models, as developed and applied in this pregnancy outcome study.

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McCann, Leo. The Paramedic at Work. Oxford University PressOxford, 2022. http://dx.doi.org/10.1093/oso/9780198816362.001.0001.

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Abstract Ambulance services and paramedics perform critical roles in contemporary healthcare economies. Trained to work in the field and respond rapidly to emergencies, societies have come to increasingly rely on ambulance services to deliver urgent care, never more so than in recent years given intense social inequality, overstretched and underfunded health systems, and deadly pandemics. This monograph is the first book-length study of the paramedic profession in England. Based on in-depth interviews and ethnographic observation The Paramedic at Work provides a detailed account of the complex realities of work in this fascinating occupation. Empirical chapters explore the nature of work ‘out on the road’, the peculiarities of ambulance organizational culture, the intensity of workplace stress and burnout, and the current and future trajectory of paramedic professionalism. The book documents the unique paradoxes experienced by those employed in this line of work. Ambulance staff are trained to handle life-threatening trauma and disease, but most callouts consist of unplanned primary care. Paramedic work features wide autonomy but is also bound into an array of micromanaging performance indicators. Paramedics are trusted and respected in society but the profession is poorly understood and employers can be unsupportive. But, no matter how intense the personal struggles can be, paramedic work also offers rare opportunities for meaningful and socially valued work. The nature of the paramedic role is rapidly moving from a manual occupation rooted in first aid and transportation, to a clinical profession of increasing scope, versatility, and social respect.

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Arnold D'Souza, Urban John, Ahmed Faris Abdullah, Atiqah Chew Abdullah et Mohammed Saffre bin Jeffree, dir. A Guide For Adressing Stress Among Medical Students. UMS Press, 2018. http://dx.doi.org/10.51200/aguideforadressingstressumspress2018.

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A Guide for Addressing Stress among Medical Students was penned by the late Associate Professor Dr Narasappa Kumaraswamy, a senior clinical psychologist and academician. He had systematically addressed the stress experienced by medical students and methods to cope them. As editors, we had the great opportunity to edit this book with our experience and present it to the world where the rich experience and research outcome of our observations help the students to understand the stress and cope it successfully during their study period. A team of editors including psychologists, psychiatrist, and physiologist, counselling experts and medical educators for decades have edited the book with their knowledge and experience as medical students earlier in their life. The medical curriculum been very vast and new technologies, information overload and in-depth subject knowledge and skills have to be learned to prepare the medical students to be life savers and helping in task of curing the health of ailing persons. Demand on holistic and integrated learning further enhanced the task of amalgamating the basic sciences and clinical knowledge that have to be mastered at a deeper level. Each year of medical course and long-hour burning out keep a student under pressure. Academic and non-academic issues and the level of stress are day-to-day affair and stress perception varies from individual to individual; some may be able to cope with their stress easily whereas a good number find difficulty in coping and may end up with psychological to psychiatric problems that need to be addressed timely. This book systematically unveils the readers to understand and take steps in dealing with stress and come over it with positive approach. This book shall help medical students and also other faculty students to understand the basis, problems with stress, coping and leading a healthy student life. Since medical studies are spread over a five long years followed by hospital housemanship, stress of life need to be balanced and systematically coping techniques shall help a student to get over the stress experience and help in leading a healthy positive student life with a good success. This book shall definitely be a guide which every student needs to read and learn everything about student stress and coping strategy. Wish all our readers the very best and happy peaceful student life rid of stress.

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