Dictionary of Evidence-based Medicine.pdf

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Dictionary of Evidence-based Medicine 101 Maryland, USA. The thesaurus is used to create the Index Medicus, a directory of major scientific publications. The MeSH thesaurus has approximately 18 000 main subjects and is regularly updated. Table 4 gives the main subject classification. Table 4 MeSH classification A B C D E F G H I J K L M N Z Anatomy Organism Diseases Drugs and chemical products Analytical, diagnostic and therapeutic techniques and equipment Psychiatry and psychology Biological sciences Physical sciences Anthropology, education, sociology and social phenomena Technology, industry, agriculture and food Humanities Information sciences and communication Named groups Health Geographical names Meta-anaiysis Meta-analysis refers to the systematic quantitative pooling of available evidence on a particular research question with the use of appropriate statistical methods. As such, it forms part of many systematic overviews. In the context of drug efficacy, clinical trial evidence is sought systematically and the relevant efficacy outcome data extracted. The data are then pooled using suitable weights such as sample variance or sample size. The pooled estimate of efficacy is then presented with the appropriate confidence bounds to define its precision. Although in medicine, meta-analysis is most widely used for pooling experimental data from randomized clinical trials (RCTs), observational data have also been meta-analysed. Methodology for incorporating observational data in meta-analyses of RCTs is also available but is not generally adopted. Most meta-analyses are undertaken on the summary data reported in the individual trials being pooled and it is usually not possible to check on any inconsistencies. However, in certain circumstances, the records of the clinical trialists may be particularly good and the network exists for obtaining the individual patient data for revalidation (e.g. cancer clinical trial networks). A meta-analysis undertaken with revalidation and
102 Dictionary of Evidence-based Medicine cross-checking of the individual patient data is called an individual patient meta-analysis. Some authors use the term 'meta-analysis' synonymously with 'systematic overview' or 'systematic review' irrespective of whether statistical pooling is undertaken. Others, rather confusingly, use the term 'nonstatistical meta-analysis' to refer to a systematic overview without statistical pooling. Over recent years, clinical trialists proposing to undertake similar trials have started to design their studies to ensure that the results can be statistically pooled on completion. A meta-analysis of the resulting data is referred to as a prospective meta-analysis. The results of a meta-analysis are usually presented graphically with confidence interval (typically 95%) estimates for the individual as well as the pooled estimates of effect (Figure 16). In a meta-analysis, if the trials are arranged sequentially in order of publication date, it is possible to provide a pooled estimate for the first two trials and then to update this estimate with each subsequent trial. A metaanalysis undertaken with this approach is called a cumulative metaanalysis. The results of such a meta-analysis are shown in Figure 17 (Li Wan Po A (1996) Evidence-based pharmacotherapy. Pharmaceutical Journal. 256: 308-12). Meta-ethnography Meta-ethnography is a method of analysis involving the comparative textual analysis of published qualitative field studies (ethnographies). In such an analysis, the approaches used are (i) combination of the individual ethnographies so that each can be presented in terms of the other; (ii) set against each other so that the basis of the refutation of one study by another can be made clear; (iii) linking of the individual studies to show how each informs or extends the others (Noblit GW, Hare RD (1988) Metaethnography: synthesizing qualitative studies. Sage Publications, Newbury Park). Microeconomics Microeconomics is one of the two main branches (the other being macroeconomics) of economic theory. It deals with the 'micro' or small economic issues such as the behaviour of individual households, firms and industries.
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Dictionary of Evidence-based Medici
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Preface This book was conceived at
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A Ability to pay Ability to pay is
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Figure I Audit: Clinical audit cycl
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B Balanced design In an experiment,
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Page 66 and 67: Figure 9 Concept of externality Dic
Page 72 and 73: G Game theory Game theory, first de
Page 86 and 87: I ICD (see International Classifica
Page 94 and 95: K Keynes, John Maynard (1883-1946)
Page 100 and 101: M Macroeconomics Macroeconomics is
Page 112 and 113: N N of I trial An N of 1 trial is a
Page 116 and 117: o OBM (see Opinion-based medicine)
Page 140 and 141: Figure 25 Measuring quality of life
Page 150 and 151: S Scarcity Scarcity is often referr
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T TDM (see Therapeutic drug monitor
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u Unique value effect This term is
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Z Z variate A random variable which
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