Up from Clinical Epidemiology & EBM

‘Clinical epidemiology’ is now widely promoted and taught as a ‘basic science’ of Evidence-Based Medicine, of clinical EBM to be specific.  This book, however, is mostly about that which Miettinen takes to be the necessary substitute for this now-so-fashionable subject – namely, Theory of Clinical Medicine together with its subordinate Theory of Clinical Research.

The leit motif in all of this is Miettinen’s perception of the need, and opportunity, to bring major improvements into clinical medicine in this Information Age, now that theoretical progress has made feasible the development of practice-guiding Expert Systems for it.

Parts of this text constitute essential reading for whoever is expected, or otherwise inclined, to study – or teach – ‘clinical epidemiology,’ and the same is true of those who set policy for the education of future clinicians; but practically all of it is essential reading for future – and current – academics in the various disciplines of clinical medicine.  After all, the text is the result of a concentrated effort, over a half-century no less, to really understand both clinical and community medicine and the research to advance the knowledge-base of these.  Research epidemiologists, too, will find this text interesting and instructive.

Acknowledgements. Foreword. Preface. Aims of the course. Abstracts. PART I. PRELIMINARIES. I – 1. ON LEADERSHIP IN CLINICAL MEDICINE. I – 2.ON MEDICAL ACADEMIA AT PRESENT.I –3. PURPORTED ESSENCE OF CLINICAL RESEARCH.I – 4.ON STUDY OF ‘CLINICAL EPIDEMIOLOGY’.I – 5. UP FROM ‘CLINICAL EPIDEMIOLOGY’ AND EBM.   PART II. THEORY OF CLINICAL MEDICINE. II – 1. THE KNOWLEDGE-BASE OF CLINICAL MEDICINE: ITS ESSENCE. II – 2. THE KNOWLEDGE-BASE OF CLINICAL MEDICINE: ITS NECESSARY FORMS.  II – 3.CODIFYING THE KNOWLEDGE-BASE OF EXPERT PRACTICE. PART III. THEORY OF CLINICAL RESEARCH. III – 1.ENHANCEMENT OF PRACTICE BY CLINICAL RESEARCH. III – 2.INTRODUCTION INTO DIAGNOSTIC CLINICAL RESEARCH.III – 3.INTRODUCTION INTO ETIOGNOSTIC CLINICAL RESEARCH. III – 4. INTRODUCTION INTO PROGNOSTIC CLINICAL RESEARCH. PART IV. CONTEMPORARY REALITIES IN CLINICAL RESEARCH. IV – 1. ON EBM GUIDELINES FOR ASSESSMENT OF EVIDENCE. IV – 2. SOME EXAMPLE STUDIES: THEIR ASSESSMENTS. PART V. EPILOGUE ON MAJOR IMPROVEMENTS IN CLINICAL MEDICINE. V – 1. THE PREDICATES OF MAJOR IMPROVEMENTS. V – 2. DEVELOPMENT OF THE MAJOR IMPROVEMENTS. V – 3.RESEARCH FOR FURTHER IMPROVEMENTS. V – 4.‘CLINICAL EPIDEMIOLOGY’ AND EBM AS SET-BACKS. Appendices.