Pragmatic Randomized Clinical Trials

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Pragmatic Randomized Clinical Trials

Author : Cynthia J. Girman
Publisher : Academic Press
ISBN 13 : 0128176644
Total Pages : 500 pages
Book Rating : 4.1/5 (281 download)

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Book Synopsis Pragmatic Randomized Clinical Trials by : Cynthia J. Girman

Download or read book Pragmatic Randomized Clinical Trials written by Cynthia J. Girman and published by Academic Press. This book was released on 2021-04-08 with total page 500 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pragmatic Randomized Clinical Trials Using Primary Data Collection and Electronic Health Records addresses the practical aspects and challenges of the design, implementation, and dissemination of pragmatic randomized trials, also sometimes referred to as practical or hybrid randomized trials. While less restrictive and more generalizable than traditional randomized controlled trials, such trials have specific challenges which are addressed in this book. The book contains chapters encompassing common designs along with advantages and limitations of such designs, analytic aspects in planning trials and estimating sample size, and how to use patient partners to help design and operationalize pragmatic randomized trials. Pragmatic trials conducted using primary data collection and trials embedded in electronic health records - including electronic medical records and administrative insurance claims - are addressed. This comprehensive resource is valuable not only for pharmacoepidemiologists, biostatisticians and clinical researchers, but also across the biomedical field for those who are interested in applying pragmatic randomized clinical trials in their research. Addresses typical designs and challenges of pragmatic randomized clinical trials (pRCTs) Encompasses analytic aspects of such trials Discusses real cases on operational challenges in launching and conducting pRCTs in electronic health records

Pragmatic Randomized Clinical Trials

Author : Cynthia J. Girman
Publisher : Elsevier
ISBN 13 : 0128176636
Total Pages : 498 pages
Book Rating : 4.1/5 (281 download)

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Book Synopsis Pragmatic Randomized Clinical Trials by : Cynthia J. Girman

Download or read book Pragmatic Randomized Clinical Trials written by Cynthia J. Girman and published by Elsevier. This book was released on 2021-04-14 with total page 498 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pragmatic Randomized Clinical Trials Using Primary Data Collection and Electronic Health Records addresses the practical aspects and challenges of the design, implementation and dissemination of pragmatic randomized trials. The book contains chapters encompassing common designs, along with the advantages and limitations of such designs, analytic aspects in planning trials and estimating sample size, and how to use patient partners to help design and operationalize such trials. Pragmatic trials conducted using primary data collection and trials embedded in electronic health records - including electronic medical records and administrative insurance claims - are addressed. This comprehensive resource is valuable not only for biostatitians, but also for several members of biomedical field who are interested in applying pragmatic randomized clinical trials in their research. Brings typical designs and challenges of pragmatic randomized clinical trials (pRCTs) Encompasses analytic aspects for sample size determination of such trials Discusses real cases on operational challenges in launching and conducting pRCTs in electronic health records

The Prevention and Treatment of Missing Data in Clinical Trials

Author : National Research Council
Publisher : National Academies Press
ISBN 13 : 030918651X
Total Pages : 163 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Prevention and Treatment of Missing Data in Clinical Trials by : National Research Council

Download or read book The Prevention and Treatment of Missing Data in Clinical Trials written by National Research Council and published by National Academies Press. This book was released on 2010-12-21 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.

Best Care at Lower Cost

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309282810
Total Pages : 437 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Best Care at Lower Cost by : Institute of Medicine

Download or read book Best Care at Lower Cost written by Institute of Medicine and published by National Academies Press. This book was released on 2013-05-10 with total page 437 pages. Available in PDF, EPUB and Kindle. Book excerpt: America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

Patient-Reported Outcomes in Performance Measurement

Author : David Cella
Publisher : RTI Press
ISBN 13 : 193483114X
Total Pages : 97 pages
Book Rating : 4.9/5 (348 download)

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Book Synopsis Patient-Reported Outcomes in Performance Measurement by : David Cella

Download or read book Patient-Reported Outcomes in Performance Measurement written by David Cella and published by RTI Press. This book was released on 2015-09-17 with total page 97 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient-reported outcomes (PROs) are measures of how patients feel or what they are able to do in the context of their health status; PROs are reports, usually on questionnaires, about a patient's health conditions, health behaviors, or experiences with health care that individuals report directly, without modification of responses by clinicians or others; thus, they directly reflect the voice of the patient. PROs cover domains such as physical health, mental and emotional health, functioning, symptoms and symptom burden, and health behaviors. They are relevant for many activities: helping patients and their clinicians make informed decisions about health care, monitoring the progress of care, setting policies for coverage and reimbursement of health services, improving the quality of health care services, and tracking or reporting on the performance of health care delivery organizations. We address the major methodological issues related to choosing, administering, and using PROs for these purposes, particularly in clinical practice settings. We include a framework for best practices in selecting PROs, focusing on choosing appropriate methods and modes for administering PRO measures to accommodate patients with diverse linguistic, cultural, educational, and functional skills, understanding measures developed through both classic and modern test theory, and addressing complex issues relating to scoring and analyzing PRO data.

The Learning Healthcare System

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309133939
Total Pages : 374 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Learning Healthcare System by : Institute of Medicine

Download or read book The Learning Healthcare System written by Institute of Medicine and published by National Academies Press. This book was released on 2007-06-01 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of health care options and decisions. The Learning Healthcare System considers how health care is structured to develop and to apply evidence-from health profession training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement-and highlights opportunities for the creation of a sustainable learning health care system that gets the right care to people when they need it and then captures the results for improvement. This book will be of primary interest to hospital and insurance industry administrators, health care providers, those who train and educate health workers, researchers, and policymakers. The Learning Healthcare System is the first in a series that will focus on issues important to improving the development and application of evidence in health care decision making. The Roundtable on Evidence-Based Medicine serves as a neutral venue for cooperative work among key stakeholders on several dimensions: to help transform the availability and use of the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and, ultimately, to ensure innovation, quality, safety, and value in health care.

Clinical Trials

Author : Timothy M. Pawlik
Publisher : Springer Nature
ISBN 13 : 3030354881
Total Pages : 254 pages
Book Rating : 4.0/5 (33 download)

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Book Synopsis Clinical Trials by : Timothy M. Pawlik

Download or read book Clinical Trials written by Timothy M. Pawlik and published by Springer Nature. This book was released on 2020-03-10 with total page 254 pages. Available in PDF, EPUB and Kindle. Book excerpt: This extensively revised second edition is a unique and portable handbook focusing on clinical trials in surgery. It includes new educational materials addressing the rapid evolution of novel research methodologies in basic science, clinical and educational research. The underlying principles of clinical trials, trial design, the development of a study cohort, statistics, data safety, data monitoring, and trial publication for device and drug trials are also discussed. Clinical Trials provides a comprehensive resource on clinical trials in surgery and describes all the stages of a clinical trial from generating a hypothesis through to trial publication and is a valuable resource for all practicing and trainee academic surgeons.

Randomized Controlled Trials

Author : Alehandro R. Jadad
Publisher : John Wiley & Sons
ISBN 13 : 1405132663
Total Pages : 170 pages
Book Rating : 4.4/5 (51 download)

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Book Synopsis Randomized Controlled Trials by : Alehandro R. Jadad

Download or read book Randomized Controlled Trials written by Alehandro R. Jadad and published by John Wiley & Sons. This book was released on 2007-07-23 with total page 170 pages. Available in PDF, EPUB and Kindle. Book excerpt: Randomized controlled trials are one of the most powerful and revolutionary tools of research. This book is a convenient and accessible description of the underlying principles and practice of randomized controlled trials and their role in clinical decision-making. Structured in a jargon-free question-and-answer format, each chapter provides concise and understandable information on a different aspect of randomized controlled trials, from the basics of trial design and terminology to the interpretation of results and their use in driving evidence-based medicine. The authors end each chapter with their musings, going beyond the evidence or citations, and sometimes even beyond orthodox correctness to share their thoughts and concerns about different aspects of randomized controlled trials, and their role within the health system. Updated to include insights from the last decade, this second edition challenges over-reliance on randomized controlled trials by debating their strengths and limitations and discussing their optimal use in modern healthcare. It also includes a new and increasingly relevant chapter on the ethics of randomized trials. World renowned writers and thinkers Drs Jadad and Enkin bring you this invaluable book for busy health professionals who wish to understand the theory of randomized controlled trials and their influence on clinical, research or policy decisions.

Randomized Clinical Trials of Nonpharmacological Treatments

Author : Isabelle Boutron
Publisher : CRC Press
ISBN 13 : 1420088025
Total Pages : 403 pages
Book Rating : 4.4/5 (2 download)

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Book Synopsis Randomized Clinical Trials of Nonpharmacological Treatments by : Isabelle Boutron

Download or read book Randomized Clinical Trials of Nonpharmacological Treatments written by Isabelle Boutron and published by CRC Press. This book was released on 2016-04-19 with total page 403 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nonpharmacological treatments include a wide variety of treatments such as surgery, technical procedures, implantable and non-implantable devices, rehabilitation, psychotherapy, and behavioral interventions. Unlike pharmacological treatments, these have no specific requirements for approval. Consequently, they can be widely proposed in clinical practice but may not have been adequately evaluated. This situation is an important barrier for the evaluation of the beneficial effects of these treatments and the conduct of clinical trials. Randomized Clinical Trials of Nonpharmacologic Treatments focuses on the methods for assessing nonpharmacological treatments, highlighting specific issues and trial design. Features: Chapters written by international experts in the field Highlights specific issues in assessing nonpharmacological treatments in trials including: how to overcome the difficulties of blinding patients, care providers, and outcome assessors the complexity of the intervention, the learning curve, and the clustering effect placebos that can be used issues of assessing harm and assessing the applicability of trials Presents a variety of trial designs for nonpharmacological treatments—including cluster randomized controlled trials, expertise-based trials, pragmatic trials, and nonrandomized trials. Provides several examples of the planning, conduct, analyses, and reporting of trials in different fields, including surgery, technical interventions, medical devices, rehabilitation, psychotherapy, and behavioral interventions. Providing practical examples that underline these issues and solutions, this book is one of the first to exclusively explore this topic, discussing various categories of treatments, from surgical procedures to psychotherapy.

Psychiatric Nonadherence

Author : Victor Fornari
Publisher : Springer
ISBN 13 : 303012665X
Total Pages : 228 pages
Book Rating : 4.0/5 (31 download)

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Book Synopsis Psychiatric Nonadherence by : Victor Fornari

Download or read book Psychiatric Nonadherence written by Victor Fornari and published by Springer. This book was released on 2019-04-04 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explores medical nonadherence to treatment and management of psychiatric disorders across the lifespan. Leading experts in the field, specializing in a range of mental health problems describe the impact of nonadherence in the treatment of children, adolescents, transition age youths, adults, and older adults. The book eloquently articulates the key elements of effective physicians and offers clinical pearls on professionalism, empathy, and the doctor-patient relationship—a key component to solving treatment nonadherence. This volume focuses on solutions for improved clinical outcomes, including communication skills, empathy and building trust, motivational interviewing techniques and the use of technology. Psychiatric Nonadherence is an excellent resource for all clinicians who care for individuals with psychiatric illness. This timely reference will provide guidance to enhance effective treatment adherence for a wide array of medical practitioners, including child and adolescent, adult forensic, and geriatric psychiatrists, addiction medicine specialists, primary care physicians, psychologists and nurses.

Clinical Epidemiology

Author : Diederick E. Grobbee
Publisher : Jones & Bartlett Learning
ISBN 13 : 1284066037
Total Pages : 450 pages
Book Rating : 4.2/5 (84 download)

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Book Synopsis Clinical Epidemiology by : Diederick E. Grobbee

Download or read book Clinical Epidemiology written by Diederick E. Grobbee and published by Jones & Bartlett Learning. This book was released on 2014-01-23 with total page 450 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now updated with new data and examples throughout, Clinical Epidemiology: Principles, Methods, and Applications for Clinical Research, Second Edition is a comprehensive resource that introduces the reader to the basics of clinical epidemiology and explores the principles and methods that can be used to obtain quantitative evidence on the effects of interventions and on the diagnosis, etiology, and prognosis of disease. The everyday challenges of clinical research and the quantitative knowledge required to practice medicine are also examined, making this book a valuable reference for both graduate and undergraduate students in medicine and related disciplines, as well as for professionals involved in the design and conduct of clinical research.

Design and Analysis of Pragmatic Trials

Author : Song Zhang
Publisher : CRC Press
ISBN 13 : 1000873552
Total Pages : 215 pages
Book Rating : 4.0/5 (8 download)

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Book Synopsis Design and Analysis of Pragmatic Trials by : Song Zhang

Download or read book Design and Analysis of Pragmatic Trials written by Song Zhang and published by CRC Press. This book was released on 2023-05-16 with total page 215 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book begins with an introduction of pragmatic cluster randomized trials (PCTs) and reviews various pragmatic issues that need to be addressed by statisticians at the design stage. It discusses the advantages and disadvantages of each type of PCT, and provides sample size formulas, sensitivity analyses, and examples for sample size calculation. The generalized estimating equation (GEE) method will be employed to derive sample size formulas for various types of outcomes from the exponential family, including continuous, binary, and count variables. Experimental designs that have been frequently employed in PCTs will be discussed, including cluster randomized designs, matched-pair cluster randomized design, stratified cluster randomized design, stepped-wedge cluster randomized design, longitudinal cluster randomized design, and crossover cluster randomized design. It demonstrates that the GEE approach is flexible to accommodate pragmatic issues such as hierarchical correlation structures, different missing data patterns, randomly varying cluster sizes, etc. It has been reported that the GEE approach leads to under-estimated variance with limited numbers of clusters. The remedy for this limitation is investigated for the design of PCTs. This book can assist practitioners in the design of PCTs by providing a description of the advantages and disadvantages of various PCTs and sample size formulas that address various pragmatic issues, facilitating the proper implementation of PCTs to improve health care. It can also serve as a textbook for biostatistics students at the graduate level to enhance their knowledge or skill in clinical trial design. Key Features: Discuss the advantages and disadvantages of each type of PCTs, and provide sample size formulas, sensitivity analyses, and examples. Address an unmet need for guidance books on sample size calculations for PCTs; A wide variety of experimental designs adopted by PCTs are covered; The sample size solutions can be readily implemented due to the accommodation of common pragmatic issues encountered in real-world practice; Useful to both academic and industrial biostatisticians involved in clinical trial design; Can be used as a textbook for graduate students majoring in statistics and biostatistics.

Small Clinical Trials

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 9780309171144
Total Pages : 222 pages
Book Rating : 4.1/5 (711 download)

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Book Synopsis Small Clinical Trials by : Institute of Medicine

Download or read book Small Clinical Trials written by Institute of Medicine and published by National Academies Press. This book was released on 2001-01-01 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.

Pharmacoepidemiology

Author : Brian L. Strom
Publisher : John Wiley & Sons
ISBN 13 : 1119413419
Total Pages : 1220 pages
Book Rating : 4.1/5 (194 download)

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Book Synopsis Pharmacoepidemiology by : Brian L. Strom

Download or read book Pharmacoepidemiology written by Brian L. Strom and published by John Wiley & Sons. This book was released on 2019-12-16 with total page 1220 pages. Available in PDF, EPUB and Kindle. Book excerpt: This classic, field-defining textbook, now in its sixth edition, provides the most comprehensive guidance available for anyone needing up-to-date information in pharmacoepidemiology. This edition has been fully revised and updated throughout and continues to provide a rounded view on all perspectives from academia, industry and regulatory bodies, addressing data sources, applications and methodologies with great clarity.

Designing Randomised Trials in Health, Education and the Social Sciences

Author : D. Torgerson
Publisher : Springer
ISBN 13 : 0230583997
Total Pages : 226 pages
Book Rating : 4.2/5 (35 download)

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Book Synopsis Designing Randomised Trials in Health, Education and the Social Sciences by : D. Torgerson

Download or read book Designing Randomised Trials in Health, Education and the Social Sciences written by D. Torgerson and published by Springer. This book was released on 2008-03-13 with total page 226 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book focuses on the design of rigorous trials rather than their statistical underpinnings, with chapters on: pragmatic designs; placebo designs; preference approaches; unequal allocation; economics; analytical approaches; randomization methods. It also includes a detailed description of randomization procedures and different trial designs.

Principles and Practice of Clinical Trials

Author : Steven Piantadosi
Publisher : Springer Nature
ISBN 13 : 3319526367
Total Pages : 2573 pages
Book Rating : 4.3/5 (195 download)

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Book Synopsis Principles and Practice of Clinical Trials by : Steven Piantadosi

Download or read book Principles and Practice of Clinical Trials written by Steven Piantadosi and published by Springer Nature. This book was released on 2022-07-19 with total page 2573 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is a comprehensive major reference work for our SpringerReference program covering clinical trials. Although the core of the Work will focus on the design, analysis, and interpretation of scientific data from clinical trials, a broad spectrum of clinical trial application areas will be covered in detail. This is an important time to develop such a Work, as drug safety and efficacy emphasizes the Clinical Trials process. Because of an immense and growing international disease burden, pharmaceutical and biotechnology companies continue to develop new drugs. Clinical trials have also become extremely globalized in the past 15 years, with over 225,000 international trials ongoing at this point in time. Principles in Practice of Clinical Trials is truly an interdisciplinary that will be divided into the following areas: 1) Clinical Trials Basic Perspectives 2) Regulation and Oversight 3) Basic Trial Designs 4) Advanced Trial Designs 5) Analysis 6) Trial Publication 7) Topics Related Specific Populations and Legal Aspects of Clinical Trials The Work is designed to be comprised of 175 chapters and approximately 2500 pages. The Work will be oriented like many of our SpringerReference Handbooks, presenting detailed and comprehensive expository chapters on broad subjects. The Editors are major figures in the field of clinical trials, and both have written textbooks on the topic. There will also be a slate of 7-8 renowned associate editors that will edit individual sections of the Reference.

Handbook of Statistics in Clinical Oncology

Author : John Crowley
Publisher : CRC Press
ISBN 13 : 142002776X
Total Pages : 642 pages
Book Rating : 4.4/5 (2 download)

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Book Synopsis Handbook of Statistics in Clinical Oncology by : John Crowley

Download or read book Handbook of Statistics in Clinical Oncology written by John Crowley and published by CRC Press. This book was released on 2005-12-01 with total page 642 pages. Available in PDF, EPUB and Kindle. Book excerpt: A compendium of cutting-edge statistical approaches to solving problems in clinical oncology, Handbook of Statistics in Clinical Oncology, Second Edition focuses on clinical trials in phases I, II, and III, proteomic and genomic studies, complementary outcomes and exploratory methods. Cancer Forum called the first edition a