
McMaster Evidence-Based Clinical Practice Workshop Resources – Therapy module
This is the therapy module resources provided to the attendees at the McMaster Evidence-Based Clinical Practice Workshop.
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McMaster Evidence-Based Clinical Practice Workshop Resources – Systematic review module
The Systematic review module resources provided to the attendees at the McMaster Evidence-Based Clinical Practice Workshop.
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How well is the clinical importance of study results reported?
How well is the clinical importance of study results reported?
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What is meant by intention to treat analysis? Survey of published randomised controlled trials
Results of a survey to document the meaning of ‘intention to treat’ analysis.
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Blinding in clinical trials and other studies
Simon Day and Doug Altman discuss blinding in clinical trials.
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Distinguishing between “no evidence of effect” and “evidence of no effect” in randomised controlled trials and other comparisons
Distinguishing between “no evidence of effect” and “evidence of no effect” in randomised controlled trials and other comparisons.
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Tips for learners of evidence-based medicine: 1. relative risk reduction, absolute risk reductions and number needed to treat
Relative risk reduction, absolute risk reduction and number needed to treat.
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Basic statistics for clinicians: 1. Hypothesis testing
The statistical concepts of hypothesis testing and p values.
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Basic statistics for clinicians: 2. Interpreting study results: confidence intervals
Interpreting study results: confidence intervals.
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Basic statistics for clinicians: 3. Assessing the effects of treatment: measures of association
Assessing the effects of treatment: measures of association.
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Tips for teachers of evidence-based medicine: Relative risk reduction, absolute risk reduction and numbers needed to treat
Tips for teachers of evidence-based medicine: 1. Relative risk reduction, absolute risk reduction and number needed to treat.
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The 2011 Oxford CEBM Levels of Evidence: Introductory Document
The 2011 Oxford Centre for Evidence-Based Medicine’s Levels of Evidence.
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Tips and tricks in performing a systematic review
Why do, and what to do when starting a systematic review.
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Meta-analysis: Its strengths and limitations
The strengths and limitations of meta-analysis.
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Meta-analysis, collaborative overview, systematic review: what does it all mean?
Mike Clarke’s 9-minute read on meta-analysis, collaborative overview, systematic review.
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The interpretation of clinical trials
Peter Greenberg’s 9-minute read on the interpretation of clinical trials.
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Evidence Based Drug Therapy: What Do the Numbers Mean?
Strengths and limitations of different measures of the effects of treatments.
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Harm
A University of Massachusetts Medical School text on adverse effects of treatments.
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Therapy
A University of Massachusetts Medical School text discussing the strengths and limitations of different measures of the effects of treatment
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What Evidence in Evidence-Based Medicine?
Philosopher John Worral’s reflections on the evidence used in Evidence-Based Medicine.
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Evidence for the frontline: A report for the Alliance for Useful Evidence
Jonathan Sharples’ introduction to evaluation in education, policing and other public services.
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Learning from research: systematic reviews for informing policy decisions
The EPPI Centre’s guide to using systematic reviews to inform policy decisions.
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Patients as Consumers: Physician’s conflicts of interest
James Rickert talks with Helen Osborne about looking at healthcare from the perspectives of both a patient and provider.
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Critical Appraisal of Research Evidence 101
Ontario Public Health Libraries Association guide to critical appraisal of research evidence.
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Policy: twenty tips for interpreting scientific claims
This list will help non-scientists to interrogate advisers and to grasp the limitations of evidence.
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What makes a good systematic review?
What makes a good systematic review from Oxford University’s Centre for Evidence-Based Intervention?
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Understanding Health Research: A tool for making sense of health studies
An interactive online tool designed to help anybody to understand scientific health research evidence.
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The Slippery Slope: Is a Surrogate Endpoint Evidence of Efficacy?
A discussion of the dangers of relying on surrogate outcome measures.
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Assessing Risk of Bias in Included Studies
An introduction to assessing risk of bias using the Cochrane ‘Risk of Bias Tool’.
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Systematic Review X Narrative Review
Describing the distinct characteristics and goals of systematic and narrative reviews of the literature.
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Reading the Medical literature
American College of Obstetricians and Gynaecologists (ACOG) introduction to critical appraisal and evidence-based medicine.
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University of Western Australia: Bias Minimisation, were the right patients included?
University of Western Australia’s explanation of the importance of involving the right people in treatment comparisons.
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University of Western Australia: Bias Minimisation, randomisation and blinding
University of Western Australia’s explanation of why random allocation to comparison groups and blinding (if possible) are important.
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Sun Downstate; The Double Blind Method
Suny Downstate’s explanation of why blinding is important in assessing the effects of treatments.
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Suny Downstate; Randomized Controlled Studies
Suny Downstate’s explanation of why random allocation to treatment comparison groups is important.
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Suny Downstate; Systematic Reviews and Meta-analysis
Suny Downstate’s explanation of why it is important to consider all studies addressing a specific question.
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What is a meta-analysis? How to use a systematic review
Oxford University’s Centre for Evidence-Based Intervention guide on how to use evidence from systematic reviews.
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What is a meta-analysis?
An explanation of meta-analysis from Oxford University’s Centre for Evidence-Based Intervention.
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Is the therapy clinically useful?
An article from the PEDro database on whether a treatment is useful.
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Is the trial valid?
An article from the PEDro database on assessing the validity of a study.
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Evidence-Based medicine in Pharmacy Practice
An article by Suzanne Albrecht on Evidence-Based Medicine in Pharmacy Practice.
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Goals and tools in Meta-analysis
Meta-analysis in Michigan State University’s Evidence-Based Medicine Course.
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Goals and tools in Prognosis evaluation
How to assess prognosis in Michigan State University’s Evidence-Based Medicine Course.
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Evaluating relevance
How to evaluate relevance of research in Michigan State University’s Evidence-Based Medicine Course.
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Limitations of current clinical practice
Discussion of the need to recognise the limitations of current clinical practice in Michigan State Univ’s Evidence-Based Medicine Course.
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Apply the results to your patients
A Duke Univ. tutorial explaining how to address the question: how relevant is the research evidence to the needs of my patient?
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What are the results?
A Duke Univ. tutorial explaining how to address the questions: How large was the treatment effect? What was the absolute risk reduction?
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Evaluating the validity of a therapy study
A web-based Duke University tutorial explaining how to address the question: are the results of the study valid?
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Delfini: Critical appraisal training video, measures of outcomes
A 15-min training video for understanding some statistics used for reporting research results.
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Delfini: Critical appraisal matters
A 20-minute slide cast discussing how reliable evidence and critical appraisal can help to improve health outcomes.
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Evidence-Based and Shared-Informed Decision-Making According to Homer (Simpson)
With help from Homer Simpson, James McCormack uses a 17-minute slide cast to explain the principles of thoughtful treatment.
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Teaching Tips: randomisation for trials
Chris Del Mar describes a group exercise that enables students to appreciate how trials work, and how they can go wrong.
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Teaching Tip: Understanding Regression to the mean in preparation for teaching EBM
Chris Del Mar uses dice to simulate the natural fluctuations in pain, and to illustrate regression-to-the mean by re-testing the outliers.
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Sunn Skepsis
Denne portalen er ment å gi deg som pasient råd om kvalitetskriterier for helseinformasjon og tilgang til forskningsbasert informasjon.
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Dancing statistics: correlation
A 4-minute film demonstrating the statistical concept of correlation through dance.
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How can you know if the spoon works?
Short, small group exercise on how to design a fair comparison using the "claim" that a spoon helps retain the bubbles in champagne.
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DRUG TOO
James McCormick with another parody/spoof of the Cee Lo Green song ‘Forget You’ to prompt scepticism about many drug treatments.
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Calling Bullshit Syllabus
Carl Bergstrom's and Jevin West's nice syllabus for 'Calling Bullshit'.
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‘Tricks to help you get the result you want from your study (S4BE)
Inspired by a chapter in Ben Goldacre’s ‘Bad Science’, medical student Sam Marks shows you how to fiddle research results.
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It’s just a phase
A resource explaining the differences between different trial phases.
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Strictly Cochrane: a quickstep around research and systematic reviews
An interactive resource explaining how systematic and non-systematic reviews differ, and the importance of keeping reviews up to date.
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The Princess and the p-value
An interactive resource introducing reporting and interpretation of statistics in controlled trials.
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Explaining the mission of the AllTrials Campaign (TED talk)
Half the clinical trials of medicines we use haven’t been published. Síle Lane shows how the AllTrials Campaign is addressing this scandal.
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Fast Stats to explain absolute risk, relative risk and Number Needed to Treat (NNT).
A 15-slide presentation on ‘Fast Stats’ to explain absolute risk, relative risk and Number Needed to Treat (NNT) prepared by PharmedOut.
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Unsubstantiated and overstated claims of efficacy
A 32-slide presentation on misleading advertisements and FDA warnings prepared by PharmedOut.
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Critical appraisal
University of New South Wales Medical Statistics Tutorial 4 addresses Critical Appraisal.
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Probability and tests of statistical significance
University of New South Wales Medical Statistics Tutorial 6 addresses ‘Probability and tests of statistical significance’.
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Bias – the biggest enemy
University of New South Wales Medical Stats Online Tutorial 5 addresses ‘Bias - the biggest enemy’.
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Introduction to Evidence-Based Medicine
Bill Caley’s 26 slides with notes used as an ‘Introduction to Evidence-Based Medicine’.
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Applying evidence to patients
A 27-minute talk on ‘Applying Evidence to Patients’, illustrated by 17 slides, with notes.
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2×2 tables and relative risk
A 10-min talk on ‘2x2 tables and Relative Risk’, illustrated by 14 slides, with notes.
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Appraisal of evidence and interpretation of results
A 14-min talk on ‘Appraisal of the Evidence and Interpretation of the Results’, illustrated by 19 slides, with notes.
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Basic principles of randomised trials, and validity
A 8-min talk on ‘Basic principles of Randomised Trials, and Validity’, illustrated by 15 slides, with notes.
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Defining clinical questions
An 8-min talk on ‘Defining Clinical Questions’ illustrated by 10 slides, with notes.
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A way to teach about systematic reviews
81 slides used by David Nunan (Centre for Evidence-Based Medicine, Oxford) to present ‘A way to teach about systematic reviews’.
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Appraising the evidence
Six key slides produced by the University of Western Australia to introduce critical appraisal.
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Taking account of the play of chance
Differences in outcome events in treatment comparisons may reflect only the play of chance. Increased numbers of events reduces this problem
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Quantifying uncertainty in treatment comparisons
Small studies in which few outcome events occur are usually not informative and the results are sometimes seriously misleading.
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Bringing it all together for the benefit of patients and the public
Improving reports of research and up-to-date systematic reviews of reliable studies are essential foundations of effective health care.
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Applying the results of trials and systematic reviews to individual patients
Paul Glasziou uses 28 slides to address ‘Applying the results of trials and systematic reviews to individual patients’.
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10 Components of effective clinical epidemiology: How to get started
PDF & Podcast of 1-hr talk by Carl Heneghan (Centre for Evidence-Based Medicine, Oxford) on effective clinical epidemiology.
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Critical appraisal of clinical trials
Slides developed by Amanda Burls for an interactive presentation covering the most important features of well controlled trials.
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Explaining the unbiased creation of treatment comparison groups and blinded outcome assessment
A class were given coloured sweets and asked to design an experiment to find out whether red sweets helped children to think more quickly.
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Systematic Reviews and Meta-analysis: Information Overload
None of us can keep up with the sheer volume of material published in medical journals each week.
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Combining the Results from Clinical Trials
Chris Cates notes that emphasizing the results of patients in particular sub-groups in a trial can be misleading.
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GenerationR – The importance of involving children and young people in research
3/3, 22-min video at the launch of GenerationR, a network of young people who advise researchers.
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Generation R – The importance of medical research in children and young people
2/3, 35-min video at the launch of GenerationR, a network of young people who advise researchers.
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No Power, No Evidence!
This blog explains that studies need sufficient statistical power to detect a difference between groups being compared.
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Beginners guide to interpreting odds ratios, confidence intervals and p values
A tutorial on interpreting odds ratios, confidence intervals and p-values, with questions to test the reader’s knowledge of each concept.
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Sample Size matters even more than you think
This blog explains why adequate sample sizes are important, and discusses research showing that sample size may affect effect size.
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What is it with Odds and Risk?
This blog explains odds ratios and relative risks, and provides the formulae for calculating both measures.
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Preclinical animal studies: bad experiments cost lives
This blog notes that few therapies that treat disease in animals successfully translate into effective treatments for humans.
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Surrogate Endpoints in EBM: What are the benefits and dangers?
What are surrogate outcomes, their pros and cons, and why you should be cautious in extrapolating from them to clinical decisions.
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The Systematic Review
This blog explains what a systematic review is, the steps involved in carrying one out, and how the review should be structured.
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The Mean: Simply Average?
This blog explains ‘the mean’ as a measure of average; describes how to calculate it; and flags up some caveats.
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Publication Bias: An Editorial Problem?
A blog challenging the idea that publication bias mainly occurs at editorial level, after research has been submitted for publication.
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The Bias of Language
Publication of research findings in a particular language may be prompted by the nature and direction of the results.
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Defining Bias
This blog explains what is meant by ‘bias’ in research, focusing particularly on attrition bias and detection bias.
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Balancing Benefits and harms
A blog explaining what is meant by ‘benefits’ and ‘harms’ in the context of healthcare interventions, and the importance of balancing them.
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Data Analysis Methods
A discussion of 2 approaches to data analysis in trials - ‘As Treated’, and ‘Intention-to-Treat’ - and some of the pros and cons of each.
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Defining Risk
This blog defines ‘risk’ in relation to health, and discusses some the difficulties in applying estimates of risk to a given individual.
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Traditional Reviews vs. Systematic Reviews
This blog outlines 11 differences between systematic and traditional reviews, and why systematic reviews are preferable.
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P Value in Plain English
Using simple terms and examples, this blog explains what p-values mean in the context of testing hypotheses in research.
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Cancer Screening Debate
This blog discusses problems that can be associated with cancer screening, including over-diagnosis and thus (unnecessary) over-treatment.
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Surrogate endpoints: pitfalls of easier questions
A blog explaining what surrogate endpoints are and why they should be interpreted cautiously.
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Misconceptions about screening
Screening should not be for everyone or all diseases. It should only be offered when it is likely to do good than harm.
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Randomized Control Trials
1/2, 40-min lecture on randomized trials by Dr R Ramakrishnan (Lecture 25) for the Central Coordinated Bioethics Programme in India.
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Compliance with protocol and follow-up in clinical trials
Denis Black’s 10-min, downloadable, PowerPoint presentation on compliance, follow up, and intention-to-treat analysis in clinical trials.
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Clinical Significance – CASP
To understand results of a trial it is important to understand the question it was asking.
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Statistical Significance – CASP
In a well-conducted randomized trial, the groups being compared should differ from each other only by chance and by the treatment received.
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P Values – CASP
Statistical significance is usually assessed by appeal to a p-value, a probability, which can take any value between 0 and 1 (certain).
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Making sense of results – CASP
This module introduces the key concepts required to make sense of statistical information presented in research papers.
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Screening – CASP
This module on screening has been designed to help people evaluate screening programmes.
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Randomised Control Trials – CASP
This module looks at the critical appraisal of randomised trials.
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Tamiflu: securing access to medical research data
A campaign by researchers has shown that Roche spun the research on Tamiflu to meet their commercial ends.
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Los intervalos de confianza en investigación
¿Para qué sirven los intervalos de confianza en los estudios de investigación?
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Watson en busca de la evidencia
Cómic acerca de conflictos de intereses y búsqueda de información.
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The need to compare like-with-like in treatment comparisons
Allocation bias results when trials fail to ensure that, apart from the treatments being compared, ‘like will be compared with like'.
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