Effectiveness & Efficiency: Random Reflections on Health Services

by A.L. Cochrane

Here is the original textbook on ‘evidence-based medicine’, a term with which few doctors and other healthcare professionals can fail to be familiar. Originally published in 1972, Archie Cochrane’s classic text has had a profound influence on the practice of medicine and on the evaluation of medical interventions. He was the first to set out clearly the vital importance of randomised controlled trials (RCTs) in assessing the effectiveness of treatments, and his work led to the setting-up of the Cochrane Collaboration, now a world-wide endeavour dedicated to tracking down, evaluating and synthesising RCTs in all areas of medicine.

The message contained in this book is as relevant to clinicians, healthcare managers and policy-makers now as it was in the 1970s. In addition, this new paperback edition of Cochrane’s work contains a brand new Introduction by Professor Chris Silagy, who was the first elected Chair of the international Cochrane Collaboration, and a Foreword by Dr Iain Chalmers, Director of the UK Cochrane Centre, the first such centre to be established. Professor Silagy looks at the post-Cochrane agenda, in particular the growth and empowerment of consumers taking more responsibility for their own healthcare decisions, and the influence of consumers on the development of an evidence-based approach to their healthcare.

Genres: Science

136 pages, Paperback

First published June 1, 1972

Reviews

[Jussi · Rating 4 out of 5]

A classic of critical thinking and separating fact from fiction — and useful from wishful — in the context of medicine. The backdrop of 1970s UK and the direction of the NHS at the time might somewhat bemuse most modern readers, but it’s still a must-read.

“One should … be delightfully surprised when any treatment at all is effective, and always assume that a treatment is ineffective unless there is evidence to the contrary.”

[Jose · Rating 5 out of 5]

Puede que Déborah Cencia lo considere anacrónico en un mundo que va directo a desmantelar la medicina tradicional y los sistemas públicos de salud gracias a los diagnósticos vía IA y la ingesta de 47 pastillas diarias por persona. Igual el fenomenal comunicador de Newtral que se parece a un cantante indie de tercera postule que qué tontería temer por la desaparición de los grupos de control y los estudios doble ciego ante la inoculación a toda la población de un tratamiento ARN biológicamente activo, si ya quedan Miguel Bosé y Enrique de Diego como grupo sobre el que aplicar mediciones observacionales de eficacia y/o estimación de daños e inadecuación. Quizá, por qué no, Don Alfredo Corell monte un taller de marionetas para explicarnos en modo Cencia Para Mongolos que lo del Señor Cochrane es una tontada ya del todo superada.

A mí, la verdad, me parece que este libro, a 50 años de haber sido publicado, toca muchísimos palos (de forma interconectada) que explican bastante bien la aberración que se lleva cometiendo desde finales de 2020 con la aplicación indiscriminada de la presunta vacuna.

Aquí disponible:

https://www.nuffieldtrust.org.uk/file...

[Gallottino · Rating 4 out of 5]

Datato ma attualissimo. L’analisi lucida di come i sistemi sanitari spendano prima di analizzare l’efficacia dei trattamenti.
Precursore della ebm quando Cochrane ci ricorda che il trattamento non solo deve essere efficace ma deve essere effettuato nelle giuste modalitá e con le necessarie modalità organizzative.
Da qui discendono tutte le valutazioni sulla necessitá o meno di avere ospedali a diversa intensitá assistenziale, di quale dimensione e con quali mezzo.
Da far leggere ai Ministri della Sanitá prima dell’insediamento

[Christopher Greeley · Rating 4 out of 5]

Short romp through the growing NHS. Some EBM sprinkled throughout. It is an ode to the rise of the RCT.

[Alan Fricker · Rating 5 out of 5]

I wish I read this years ago. A bit of biography, a ramble through the need for evidence and a lot of love for the RCT. Plenty of clear examples. All with a gentle bit of fun poking. Makes me wish I studied medicine so that I would understand more of the jokes.

[Sergio Uribe]

The real introduction to evidence based medicine