Interpreting the Medical Literature Applying Evidence Based Medicine in Practice

Jeff Susman, Bernard Ewigman, Keith B. Holten, and Douglas R. Smucker

Chapter contents

Building Clinical Evidence from Published Research


Interpreting Study Results: Statistical and Clinical Significance 115

Case-Control Studies


Other Keys to Interpreting Clinical Evidence 115

Cohort Studies


Using Evidence at the Point of Care 116

Structured Reviews and Meta-Analysis


Case Example 116

The Power of Randomized, Controlled Trials


Evidence Levels 119

Understanding the Statistical Significance of Study Results


• Interpreting the medical literature is a task any physician can do, particularly when using common, evidence-based summaries that are available at low or no cost.

• The studies should report statistically significant results that are applicable to the physician's population of patients and that should evaluate important patient-oriented outcomes, including potential harms.

• When potentially changing practice behavior, the physician should assess whether the evidence is from high-quality studies replicated over time.

• The medical literature is an evolving body of evidence, and each physician should develop a personal plan to keep up with important changes in medicine and strategies to answer more immediately important clinical questions at the point of care.

• Using summary measures, such as the number needed to treat or harm and attributable risk, can make decisions about patient care more collaborative and transparent

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