Clinical Trials in Psychiatry

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Author :
Publisher : John Wiley & Sons
ISBN 13 : 9780470723845
Total Pages : 248 pages
Book Rating : 4.7/5 (238 download)

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Book Synopsis Clinical Trials in Psychiatry by : Brian S. Everitt

Download or read book Clinical Trials in Psychiatry written by Brian S. Everitt and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: At last – a new edition of the highly acclaimed book Clinical Trials in Psychiatry This book provides a concise but thorough overview of clinical trials in psychiatry, invaluable to those seeking solutions to numerous problems relating to design, methodology and analysis of such trials. Practical examples and applications are used to ground theory whenever possible. The Second Edition includes new information regarding: Recent important psychiatric trials More specific discussion of psychiatry in the USA and the particular problems of trials in the USA, including comments about the FDA (U.S. Food and Drug Administration) An extended chapter on meta-analysis Further discussion of sub-group analysis Special features include appendices outlining how to design and report clinical trials, what websites and software programs are appropriate and an extensive reference section. From the reviews of the First Edition: “Everitt & Wessely are to be congratulated on producing an excellent guide to help overcome the snags in clinical trial research. Clearly written and in an engrossing style, the book is likely to become a classic textbook on clinical trials, and not just in psychiatry. The authors’ enthusiasm and grasp of clinical trial research make for a gripping and insightful read...it is one of the very best books that has been written on clinical trials.” THE BRITISH JOURNAL OF PSYCHIATRY "The experience of both authors in this area gives the book a very pragmatic approach grounded in reality, with theoretical overviews invariably being followed by practical examples and applications... an invaluable companion to anyone involved in, or contemplating undertaking, clinical trials research.” PSYCHOLOGICAL MEDICINE

50 Studies Every Psychiatrist Should Know

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Publisher : Oxford University Press
ISBN 13 : 0190625082
Total Pages : 377 pages
Book Rating : 4.1/5 (96 download)

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Book Synopsis 50 Studies Every Psychiatrist Should Know by : Ish P. Bhalla

Download or read book 50 Studies Every Psychiatrist Should Know written by Ish P. Bhalla and published by Oxford University Press. This book was released on 2018 with total page 377 pages. Available in PDF, EPUB and Kindle. Book excerpt: 50 Studies Every Psychiatrist Should Know presents key studies that have shaped the practice of psychiatry. Selected using a rigorous methodology, the studies cover topics including: psychotic disorders, depressive disorders, women's mental health, child and adolescent disorders, and epidemiological studies. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies. This book is a must-read for health care professionals and anyone who wants to learn more about the data behind clinical practice.

Transforming Clinical Research in the United States

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Publisher : National Academies Press
ISBN 13 : 0309163358
Total Pages : 151 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Transforming Clinical Research in the United States by : Institute of Medicine

Download or read book Transforming Clinical Research in the United States written by Institute of Medicine and published by National Academies Press. This book was released on 2010-10-22 with total page 151 pages. Available in PDF, EPUB and Kindle. Book excerpt: An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.

Landmark Papers in Psychiatry

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Publisher : Oxford University Press
ISBN 13 : 019253887X
Total Pages : 449 pages
Book Rating : 4.1/5 (925 download)

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Book Synopsis Landmark Papers in Psychiatry by : Elizabeth Ryznar

Download or read book Landmark Papers in Psychiatry written by Elizabeth Ryznar and published by Oxford University Press. This book was released on 2020-01-22 with total page 449 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advances in the practice of psychiatry have occurred in "fits and starts" over the last several decades. These advances are evident to anyone long affiliated with the field and are best appreciated through direct experience of living through the times. These advances can also be gleaned from historical overviews in textbooks or the recollections of one's teachers and mentors. Returning to the original papers that have ushered in these changes is rarely done for various, mostly practical, reasons. Filtering through thousands of articles in psychiatry may prove daunting, access to the manuscripts may be limited (especially for papers not available electronically), and understanding their impact requires a broader context. Moreover, with so much active research currently occurring in various branches of psychiatry, current practitioners or trainees may find their attention focused on the present, and this is reinforced by electronic search algorithms, which return articles in reverse chronological order. Not surprisingly, citations for articles in virtually all fields decline precipitously for articles over five years old. As scholars and professionals, we are losing touch with our academic heritage. Yet navigating the future of psychiatry requires a firm understanding of its past. This resource serves as a guide for anyone seeking to understand the evolution of psychiatry as a scientific discipline. It does so by summarizing over 100 landmark papers in psychiatry and placing their scientific contributions within a historical context. An introductory section sets the stage for the major theoretical constructs within the field, with chapters devoted to ontology and nosology. Subsequent sections examine major facets of the theory and practice of psychiatry, such as pathogenesis of psychiatric illness, pharmacotherapy, psychotherapy, and somatic treatments. These sections are divided logically into chapters addressing important contributions to the understanding and treatment of specific disorders. A final section explores ethical considerations within each field. This framework echoes the complexity of psychiatry, which cannot be reduced to a single set of diagnoses or subspecialty categories. Highlighting the research trajectory of psychiatry, this resource will appeal to academics, trainees, and practitioners who desire a comprehensive, easy-to-read, up-to-date collection of psychiatry's pivotal moments. By understanding the challenges, inspirations, and insights from the past, readers will be better poised to address new and ongoing challenges within the field.

Clinical Trials in Psychiatry

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Author :
Publisher :
ISBN 13 : 9781383024425
Total Pages : 0 pages
Book Rating : 4.0/5 (244 download)

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Book Synopsis Clinical Trials in Psychiatry by : Brian Everitt

Download or read book Clinical Trials in Psychiatry written by Brian Everitt and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: 'Clinical Trials in Psychiatry' explains RCTs for mental health professionals. It starts by discussing why we need trials and why they are the best way of deciding if a treatment works. It then describes the different types of trial, how to analyze the results, and how to conduct a trial.

Clinical Trials in Psychopharmacology

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Publisher : John Wiley & Sons
ISBN 13 : 9780470749173
Total Pages : 406 pages
Book Rating : 4.7/5 (491 download)

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Book Synopsis Clinical Trials in Psychopharmacology by : Marc Hertzman

Download or read book Clinical Trials in Psychopharmacology written by Marc Hertzman and published by John Wiley & Sons. This book was released on 2010-03-16 with total page 406 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although clinical trials were virtually unheard of in psychiatry for many years, they are now the gold standard for judging whether drugs are safe and useful. But should they be? What is the true status of clinical trials? Even when they ostensibly demonstrate a benefit of a certain treatment, the strict patient selection criteria, poor compliance and high drop-out rate leave the conclusions open to question. Are the new treatments really better or more cost-effective than the old? Do they have fewer side effects? In this book the authors take a critical look at recent developments and present a series of trenchant and challenging observations. Section I examines the significant changes in law and the regulatory environment that have occurred during the past ten years. Has fossilization handicapped the US Food and Drug Administration in promoting treatment advances? How can the plethora of findings be regulated? This is particularly pertinent in genomic studies and there are two chapters addressing the impact of genomics on psychiatric research. This section also addresses the role of women in drug trials – a group long excluded but now demanding a part, for without testing how can optimal treatments be devised? The next two Sections highlight clinical trials in the major areas of psychiatric pharmacological treatment, including Mood Disorders, especially Bipolar, Anxiety Disorders, and addictions. Chapters on pharmacological treatments for Eating Disorders, Attention Deficit Disorder, Autism and Asperger’s Syndrome, and Impulse Control Disorder represent the latest thinking on these subjects. The final Section contains a consummate example of out-of-the [Western]- box thinking, namely consideration of herbal medicines – used by a large number of patients, with or without medical supervision. We conclude with a close look at the problem of side effects, then selected thoughts about methodology. Clearly written, the text provides immediate access to new developments across the spectrum of drug testing. Clinical Trials in Psychopharmacology: A Better Brain is provocative reading for psychiatrists, pharmacologists and all those interested in improved drug treatments for patients with mental illness. Raises questions about the conduct of trials and the credibility of their outcomes that are relevant not just in psychiatry but all areas of medicine Discusses the ethical problems in assessing outcomes in humans, including children

Elements of Clinical Research in Psychiatry

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Publisher : American Psychiatric Pub
ISBN 13 :
Total Pages : 232 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Elements of Clinical Research in Psychiatry by : James Edward Mitchell

Download or read book Elements of Clinical Research in Psychiatry written by James Edward Mitchell and published by American Psychiatric Pub. This book was released on 2000 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical research is often thought of as a dry and somewhat arcane pursuit. Not so, assert the editors of Elements of Clinical Research in Psychiatry. The editors, all actively engaged in clinical research, bring this topic to life by combining a boundless enthusiasm for their chosen field with a depth of knowledge rarely seen in the literature. They show that clinical research can be rewarding not only because the research results contribute to improving the welfare of psychiatric patients, but also because the research process itself is exciting. Arguably the definitive guidebook on clinical psychiatric research, this volume discusses * Careers in clinical mental health research -- Describes what clinical psychiatric researchers do and how to get started on this career path. * Research design, measurement, and assessment -- Covers all aspects of research design, defines and evaluates measurement types, and details various assessment methods (from interviews and questionnaires to lab tests and brain images). * Descriptive and inferential statistics -- Shows how statistics are used to analyze and summarize measurement data. * Research support -- Provides a roadmap for those seeking research support in the U.S. (more than 90% is funded via NIH), detailing how to write grants from the ground up. * Use of human subjects (the Institutional Review Board [IRB]) and ethics and misconduct -- Demystifies the often intimidating process of seeking and receiving IRB approval, with tips on how to work with the IRB and complete its consent forms; uses a series of practical scenarios, including a highly publicized case of alleged misconduct, to illustrate complex ethics and misconduct issues. * Writing journal articles, reviewing manuscripts, and giving scientific presentations -- Presents the nuts and bolts of publishing journal articles; gives step-by-step advice for reviewing manuscripts and giving oral presentations, symposia, poster sessions, and colloquia. Carefully chosen appendixes provide readers with additional information they can use right away, augmented by an index and detailed reference list for further investigation. Anyone considering clinical psychiatric research as a career option will find in this succinct and eminently practical volume the single source they need. Practicing psychiatrists interested in specific areas of clinical research, such as human subject use or biomedical ethics, will also find much of interest here. Replete with useful information, these stimulating discussions provide the building blocks for embarking upon -- and enhancing -- a successful career in clinical psychiatric research.

Research Training in Psychiatry Residency

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Publisher : National Academies Press
ISBN 13 : 0309090717
Total Pages : 271 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Research Training in Psychiatry Residency by : Institute of Medicine

Download or read book Research Training in Psychiatry Residency written by Institute of Medicine and published by National Academies Press. This book was released on 2004-01-23 with total page 271 pages. Available in PDF, EPUB and Kindle. Book excerpt: The number of psychiatric researchers does not seem to be keeping pace with the needs and opportunities that exist in brain and behavioral medicine. An Institute of Medicine committee conducted a broad review of the state of patient-oriented research training in the context of the psychiatry residency and considered the obstacles to such training and strategies for overcoming those obstacles. Careful consideration was given to the demands of clinical training. The committee concluded that barriers to research training span three categories: regulatory, institutional, and personal factors. Recommendations to address these issues are presented in the committee's report, including calling for research literacy requirements and research training curricula tailored to psychiatry residency programs of various sizes. The roles of senior investigators and departmental leadership are emphasized in the report, as is the importance of longitudinal training (e.g., from medical school through residency and fellowship). As there appears to be great interest among numerous stakeholders and a need for better tracking data, an overarching recommendation calls for the establishment of a national body to coordinate and evaluate the progress of research training in psychiatry.

Global Mental Health Trials

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Publisher : OUP Oxford
ISBN 13 : 0191501646
Total Pages : 358 pages
Book Rating : 4.1/5 (915 download)

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Book Synopsis Global Mental Health Trials by : Graham Thornicroft

Download or read book Global Mental Health Trials written by Graham Thornicroft and published by OUP Oxford. This book was released on 2014-06-19 with total page 358 pages. Available in PDF, EPUB and Kindle. Book excerpt: Global mental health is a dynamic field of global health; a core aspect of the story which has led to its emergence has been the conduct of randomised controlled trials (RCTs) evaluating innovative delivery systems of packages of care for mental disorders in low-resource settings. Global Mental Health Trials brings together many of the world's leading researchers active in the fields of RCTs in low- and medium-resource countries and settings related to improving mental health care. It presents clear and practical information about how to conduct such trials in these settings, along with critical methodological and ethical issues related to such trials, learning from the positive and negative experiences of expert scientists in many countries worldwide who have completed such trials. This book serves as a valuable resource for practitioners in mental health - psychiatrists, psychiatric nurses nursing, psychologists, social workers, and occupational therapists - as well as researchers in the areas of psycho-social treatments in mental health, mental health services research, and programme and systems evaluation.

Antipsychotic Trials in Schizophrenia

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Publisher : Cambridge University Press
ISBN 13 : 1139487574
Total Pages : pages
Book Rating : 4.1/5 (394 download)

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Book Synopsis Antipsychotic Trials in Schizophrenia by : T. Scott Stroup

Download or read book Antipsychotic Trials in Schizophrenia written by T. Scott Stroup and published by Cambridge University Press. This book was released on 2010-04-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Antipsychotic medications are a key treatment for schizophrenia and sales of antipsychotic drugs approach $20 billion per year, with fierce marketing between the makers of the drugs. The U.S. National Institute of Mental Health sponsored the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project to provide independent information about the comparative effectiveness of medications. CATIE was the largest, longest and most comprehensive study of schizophrenia to date. Conducted under rigorous double-blind conditions, Antipsychotic Trials in Schizophrenia presents the definitive archival results of this landmark study. The core of the book consists of chapters focused on specific outcomes that set the CATIE findings in a wider context. Also included are chapters on the design, statistical analyses and implications for researchers, clinicians and policy makers. Psychiatrists, psychiatric researchers, mental health policy makers and those working in pharmaceutical companies will all find this to be essential reading.

Clinical Trials in Psychiatry

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Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (139 download)

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Book Synopsis Clinical Trials in Psychiatry by :

Download or read book Clinical Trials in Psychiatry written by and published by . This book was released on with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Research Methods in Psychiatry

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Publisher : RCPsych Publications
ISBN 13 : 9781904671336
Total Pages : 366 pages
Book Rating : 4.6/5 (713 download)

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Book Synopsis Research Methods in Psychiatry by : Chris Freeman

Download or read book Research Methods in Psychiatry written by Chris Freeman and published by RCPsych Publications. This book was released on 2006-12 with total page 366 pages. Available in PDF, EPUB and Kindle. Book excerpt: This updated comprehensive guide to psychiatric research methods takes the reader from getting started in research through to publishing a paper, with advice on avoiding common pitfalls along the way. Systematic analysis and meta-analysis, epidemiology, qualitative research, and research focused on a few patients are discussed, together with the principles of validity and reliability in the assessment of psychological variables and statistical aspects of the design and analysis of clinical trials. Five completely new chapters cover topics such as research from the trainee's perspective and research in learning disability and child and adolescent psychiatry. A key text for psychiatric trainees embarking on research projects, this book will also be useful to psychiatrists supervising research projects, and those in the social sciences with an interest in carrying out research or critically reviewing the published evidence. Topics covered include setting up a research project, how to make a comprehensive review of the literature, choosing a rating scale, and getting research published.

Personalized Psychiatry

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Publisher : Academic Press
ISBN 13 : 0128131772
Total Pages : 604 pages
Book Rating : 4.1/5 (281 download)

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Book Synopsis Personalized Psychiatry by : Bernhard Baune

Download or read book Personalized Psychiatry written by Bernhard Baune and published by Academic Press. This book was released on 2019-10-16 with total page 604 pages. Available in PDF, EPUB and Kindle. Book excerpt: Personalized Psychiatry presents the first book to explore this novel field of biological psychiatry that covers both basic science research and its translational applications. The book conceptualizes personalized psychiatry and provides state-of-the-art knowledge on biological and neuroscience methodologies, all while integrating clinical phenomenology relevant to personalized psychiatry and discussing important principles and potential models. It is essential reading for advanced students and neuroscience and psychiatry researchers who are investigating the prevention and treatment of mental disorders. Combines neurobiology with basic science methodologies in genomics, epigenomics and transcriptomics Demonstrates how the statistical modeling of interacting biological and clinical information could transform the future of psychiatry Addresses fundamental questions and requirements for personalized psychiatry from a basic research and translational perspective

Research Methods in Psychiatry

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Publisher :
ISBN 13 :
Total Pages : 332 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Research Methods in Psychiatry by : Chris Freeman

Download or read book Research Methods in Psychiatry written by Chris Freeman and published by . This book was released on 1992 with total page 332 pages. Available in PDF, EPUB and Kindle. Book excerpt:

How to Practice Evidence-Based Psychiatry

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Publisher : American Psychiatric Pub
ISBN 13 : 1585629227
Total Pages : 388 pages
Book Rating : 4.5/5 (856 download)

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Book Synopsis How to Practice Evidence-Based Psychiatry by : C. Barr Taylor

Download or read book How to Practice Evidence-Based Psychiatry written by C. Barr Taylor and published by American Psychiatric Pub. This book was released on 2009-10-30 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: The use of evidence-based guidelines and algorithms is widely encouraged in modern psychiatric settings, yet many practitioners find it challenging to apply and incorporate the latest evidence-based psychosocial and biological interventions. Now, practitioners have an outstanding new resource at their fingertips. How to Practice Evidence-Based Psychiatry: Basic Principles and Case Studies accomplishes two goals: it explains the methods and philosophy of evidence-based psychiatry, and it describes ways in which psychiatrists and other mental health specialists can incorporate evidence-based psychiatry into their clinical practices. Uniquely relevant to psychiatric clinicians, this is the only book on evidence-based medicine specific to the field of psychiatry that addresses integrated psychopharmacology and psychotherapies. This new book first provides an expansion on the popular text the Concise Guide to Evidence-Based Psychiatry, updating the sections on clinical trials, the teaching of evidence-based medicine, and the effective treatment of patients with complex comorbid conditions. It then allows experts from a variety of specialty areas and practice settings to describe how they incorporate the latest evidence and outcome studies into interesting and inspiring cases of their own. The book starts with the assumption that clinicians must adapt guidelines, algorithms, other sources of evidence, and the interpretation of this evidence to each individual patient. It describes basic statistical concepts in an easily understood format and offers separate chapters devoted to systematic reviews and meta-analyses, clinical practice guidelines, diagnostic tests, surveys of disease frequency, and prognosis and psychometric measurement. It also presents an easily relatable discussion of many of the major issues of evidence-based psychiatry, such as use of the "Five-Step" evidence-based medicine model. The first section can be used both as an introduction to the topic and a ready reference for researching the literature and appraising evidence. The second section includes relevant case examples of major psychiatric disorders, and the third presents case examples from diverse treatment settings. In these sections, 24 contributing clinicians from a variety of practice settings discuss situations in which they followed aspects of evidence-based care. The text includes tables and charts throughout the text, including algorithms, guidelines, and examples of simple, therapist-devised measures of progress, further enhance learning, retention, and clinical practice. How to Practice Evidence-Based Psychiatry: Basic Principles and Case Studies is a valuable new tool that will help residents, practicing psychiatrists, and other mental health workers find the most useful and relevant information to inform and improve their everyday practices.

Clinical Trial Design Challenges in Mood Disorders

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Publisher : Academic Press
ISBN 13 : 0124051766
Total Pages : 192 pages
Book Rating : 4.1/5 (24 download)

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Book Synopsis Clinical Trial Design Challenges in Mood Disorders by : Mauricio Tohen

Download or read book Clinical Trial Design Challenges in Mood Disorders written by Mauricio Tohen and published by Academic Press. This book was released on 2015-01-24 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: Poor clinical trial designs result in failed studies wasting research funds and limiting the advancement of cures for disorders. Clinical Trial Design Challenges in Mood Disorders outlines classic problems researchers face in designing clinical trials and discusses how best to address them for the most definitive and generalizable results. Traditional trial designs are included as well as novel analytic techniques. The book examines information on high placebo response, the generalizability of studies conducted in the developing world, the duration of maintenance studies, and the application of findings into clinical practice. With representation from contributors throughout the world and from academia, industry, regulatory agencies, and advocacy groups, this book will contribute toward improved clinical trial design and valid, precise, and reliable answers about what works better and faster for patients. Summarizes common trial design problems and their solutions Encompasses funding, subject selection, regulatory issues and more Identifies best practices for definitive and generalizable results Includes traditional trial designs and novel analytic techniques Represents academia, industry, regulatory agencies, and advocacy groups

Clinical Trials of Antidepressants

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Author :
Publisher : Springer
ISBN 13 : 3319264648
Total Pages : 71 pages
Book Rating : 4.3/5 (192 download)

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Book Synopsis Clinical Trials of Antidepressants by : Martin M. Katz

Download or read book Clinical Trials of Antidepressants written by Martin M. Katz and published by Springer. This book was released on 2016-02-08 with total page 71 pages. Available in PDF, EPUB and Kindle. Book excerpt: This brief guide takes current clinical trial protocols to task and replaces them with a contemporary framework for improving next-generation antidepressants and their underlying science. Innovative models are based on a nuanced, neurologically-informed understanding of drug mechanisms and the component cognitive, mood, and behavioral aspects of depression. The book reconceptualizes not only the clinical trial process but the clinical concept of depression itself as essential to bringing pharmaceutical research and development up to date, boosting efficiency and effectiveness, finding new molecules, and reducing waste. Case studies and a review of salient depression scales illustrate the potential benefits of such wide-scale change. Included in the coverage: Why now the need for a new clinical trials model for antidepressants? Aims and basic requirements of clinical trials: conventional and component-specific models. Methods for measuring the components and the profile of drug actions: the multivantaged approach. Achieving the ideal clinical trial: an example of the merged componential and established models. Prediction and shortening the clinical trial. The video clinical trial. Clinical Trials of Antidepressants will interest a varied audience, including clinical investigators, academic and pharmaceutical company scientists, clinical trial organizations, psychiatrists, outpatient physicians, psychotherapists, clinical psychologists, psychology graduate students, medical students, and government agencies such as the FDA.