How do we know whether a particular drug, therapy or operation really works, and how well? How reliable is the clinical evidence? Are clinical trials truly unbiased? And is current research fully focused on the real needs of patients? Such timely questions are raised and resolved in this probing inquiry into modern clinical research, with far reaching implications for daily medical practice and patient care. Aimed at both patients and professionals, Testing Treatments builds a lively and thought-provoking argument for better, more reliable, more relevant research, with unbiased or fair trials, and explains how patients can work with doctors to achieve this vital goal. Expertly and thoroughly researched, but never dry or dull, the fast-moving commentary spans the gamut of illness and therapy from mastectomy to thalidomide and explores a range of case-studies, enlivened throughout by accounts drawn from the direct experience of patients, practitioners and researchers.
As the evidence unfolds, it becomes glaringly obvious how some treatments have been at best inadequate, at worst harmful, and how inadequately tested many treatments remain. While outlining the goals of good research and how best to achieve unbiased results, including the use of randomised clinical trials, the authors also highlight the inevitable uncertainties surrounding the effects of treatment, as well as the commercial and academic interests that invariably shape what research gets done. Often startling, at times unsettling, Testing Treatments urges everyone to take an active part in changing conditions, and describes what practical steps doctors and patients can together take to improve current research and future treatment.
This fascinating book explores many examples of the limitations of clinical evidence and make a powerful plea for partnership between patients and professionals in sharing uncertainty and pursuing research. Harry Cayton, National Director for Patients and the Public, Department of Health.
An eloquent and impassioned plea for better, rather than more, research. It also calls for full admission of uncertainty about the effect of so much of what doctors do and recommend. Margaret McCartney, Financial Times
AUTHORS
Imogen Evans, practised and lectured in medicine in
Hazel Thornton, was invited to join a clinical trial, but the inadequate patient information led to her refusal. However, it also encouraged her advocacy for public involvement in research. She has written and spoken extensively on this topic.
Iain Chalmers, practised medicine before becoming a health services researcher and directing the National Perinatal Epidemiology Unit and then the UK Cochrane Centre. Since 2002 he has co-ordinated the James Lind Initiative, promoting better controlled trials, particularly through greater public involvement.
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