Up from Clinical Epidemiology & EBM

Description

‘Clinical epidemiology’ is now widely promoted and taught as a ‘basic science’ of Evidence-Based Medicine, of clinical EBM to be specific. This book, however, is mostly about that which Miettinen takes to be the necessary substitute for this now-so-fashionable subject – namely, Theory of Clinical Medicine together with its subordinate Theory of Clinical Research.The leit motif in all of this is Miettinen’s perception of the need and opportunity to bring major improvements into clinical medicine in this Information Age, now that theoretical progress has made feasible the development of practice-guiding Expert Systems for it. Parts of this text constitute essential reading for whoever is expected, or otherwise inclined, to study – or teach – ‘clinical epidemiology,’ and the same is true of those who set policy for the education of future clinicians; but practically all of it is essential reading for future – and current – academics in the various disciplines of clinical medicine. After all, the text is the result of a concentrated effort, over a half-century no less, to really understand both clinical and community medicine and the research to advance the knowledge-base of these. Research epidemiologists, too, will find this text interesting and instructive. Front Matter....Pages i-xxiii Front Matter....Pages 1-1 On Leadership in Clinical Medicine....Pages 3-4 On Medical Academia at Present....Pages 5-9 Purported Essence of Clinical Research....Pages 11-12 On Study of ‘Clinical Epidemiology’....Pages 13-14 Up from ‘Clinical Epidemiology’ & EBM....Pages 15-20 Front Matter....Pages 21-21 The Knowledge-Base of Clinical Medicine: Its Essence....Pages 23-32 The Knowledge-Base of Clinical Medicine: Its Necessary Forms....Pages 33-40 Codifying the Knowledge-Base of Expert Practice....Pages 41-49 Front Matter....Pages 51-51 Enhancement of Practice by Clinical Research....Pages 53-58 Introduction into Diagnostic Clinical Research....Pages 59-64 Introduction into Etiognostic Clinical Research....Pages 65-70 Introduction into Prognostic Clinical Research....Pages 71-79 Front Matter....Pages 81-81 On EBM Guidelines for Assessment of Evidence....Pages 83-87 Some Example Studies: Their Assessments....Pages 89-128 Front Matter....Pages 129-129 The Predicates of Major Improvements....Pages 131-132 Development of the Major Improvements....Pages 133-134 Research for Further Improvements....Pages 135-135 ‘Clinical Epidemiology’ & EBM as Set-Backs....Pages 137-138 Front Matter....Pages 139-139 Some Elementary Concepts of Medicine, According to the Students....Pages 141-145 On the Students’ Concepts, the Teacher’s Comments....Pages 147-149 Front Matter....Pages 139-139 Assignments to the Students....Pages 151-156 To the Assignments, the Teacher’s Responses....Pages 157-166 More on Garnering Experts’ Tacit Knowledge....Pages 167-169 An Industrial Perspective....Pages 171-173 Back Matter....Pages 175-175