Evidence Synthesis in Healthcare A Practical Handbook for Clinicians
Evidence Synthesis in Healthcare – a Practical Handbook for Clinicians is the first book to reveal the field of Evidence Synthesis, by combining multiple sources of quantitative and qualitative data to derive the best evidence for use in healthcare.
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Thanos Athanasiou • Ara Darzi (Editors)
Evidence Synthesis in Healthcare A Practical Handbook for Clinicians
Editors Thanos Athanasiou, PhD, MD, FETCS Department of Surgery and Cancer Imperial College London St. Mary’s Hospital Campus London, UK
Prof. Ara Darzi, PC, KBE, FMedSci, HonFREng Department of Surgery and Cancer Imperial College London St. Mary’s Hospital Campus London, UK
ISBN 978-0-85729-175-2 e-ISBN 978-0-85729-206-3 DOI 10.1007/978-0-85729-206-3 Springer London Dordrecht Heidelberg New York British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Control Number: 2011921693 © Springer-Verlag London Limited 2011 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licenses issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc., in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Cover design: eStudioCalamar, Figueres/Berlin Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface
Modern healthcare is now fundamentally dependent on decisions that are based on the best evidence available. The current era of evidence-based healthcare has led to a revolution in our understanding of diseases and their treatments. It has also transformed modern medical practice and the training of all levels of healthcare workers. As a result the enhancement of clinical skills is unavoidably intertwined with a basic knowledge of research and methodology. Acquiring the best evidence is not always straightforward as there is a wide heterogeneity between types of evidence and the variability for each distinct disease, environment and patient population. Sometimes, the evidence is totally non-existent for a specific complaint, whilst other times a large discrepancy exists between evidence sources. The increased application of robust statistics to healthcare research led to a tipping point in our realisation of diseases processes and their management. The introduction of techniques such as meta-analysis and systematic reviews permitted the mathematical amalgamation of several quantitative studies to derive a unified overall result or treatment conclusion from a
