Abstract:
:The uses of hypothesis in scientific medicine and in clinical medicine are broadly similar; but they differ in subtle but important logical details. The key distinction is that scientific medicine deals with broad ("public") hypotheses about entire populations; and the predominant problem of inference is statistics in the face of epistemological uncertainty. In contrast, clinical medicine deals with individual, tailor-made ("private") hypotheses; the uncertainty (e.g. the diagnosis or recurrence risk in relatives) is ontological, and the main feature of the analysis is probability. The same logical rules are at times mistakenly applied to both. Disregard of these subtleties may lead to paradoxes, contradictions, and at times diastrously false conclusion. The basic principles and distinctions are laid out with illustrations that are most readily provided from medical genetics, but apply to all branches of medicine.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Murphy EAdoi
10.1016/0895-4356(89)90028-0subject
Has Abstractpub_date
1989-01-01 00:00:00pages
79-84issue
1eissn
0895-4356issn
1878-5921pii
0895-4356(89)90028-0journal_volume
42pub_type
杂志文章abstract:OBJECTIVES:The aim was to construct and validate algorithms for osteoporosis case ascertainment from administrative databases and to estimate the population prevalence of osteoporosis for these algorithms. STUDY DESIGN AND SETTING:Artificial neural networks, classification trees, and logistic regression were applied t...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2008.02.002
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:In the development of search strategies for systematic reviews, "conceptual approaches" are generally recommended to identify appropriate search terms for those parts of the strategies for which no validated search filters exist. However, "objective approaches" based on search terms identified by text analys...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2016.05.002
更新日期:2016-09-01 00:00:00
abstract::Accurate prognosis is critical to the design of all prospective research aimed at improving survival. Predictions based on birth weight, gestational age, or any other single variable, fail to take into account the potentially important contribution of other factors. In order to develop a practical and accurate multiva...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章
doi:10.1016/0895-4356(88)90079-0
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To develop a questionnaire with which to measure quality of life (QoL) in patients with knee and hip osteoarthritis (OA). STUDY DESIGN AND SETTING:Thirty-two caregivers and 96 OA patients were interviewed individually (using cognitive and face-to-face techniques) and in focus groups. A group of experts worki...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2004.04.011
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:There is a growing evidence base on methods to improve response rates in surveys among patients. This study aimed to determine the additional effect of two intensive follow-up procedures compared to a simple follow-up procedure. METHODS:Randomized controlled trial that compared repeated mailin...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jclinepi.2005.03.002
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:The uptake of research findings into routine health care is a haphazard and unpredictable process. The usefulness of the results of implementation studies is limited, due in part to the lack of an underlying framework of the important dimensions of research studies in this area and the healthcare settings wit...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.09.002
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To assess the impact of including unpublished data on adverse effects in systematic reviews. STUDY DESIGN AND SETTING:We carried out a systematic review of methodological evaluations that compared the quantitative reporting of adverse effects data between published and unpublished sources, in particular, the...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.02.009
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVES:To investigate whether the relationship between demographic and disease-related variables and disability is constant during the first five years of inflammatory polyarthritis (IP) and to identify the contribution from involvement of specific joint areas to overall disability. METHODS:684 patients referred t...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(00)00189-x
更新日期:2000-10-01 00:00:00
abstract::The relationships between the prevalence of hepatitis B surface antigen (HBsAg), mean annual per capita alcohol consumption and primary liver cancer (PLC) death rates were explored in 30 countries. HBsAg prevalence was associated, significantly, with the logarithm of the primary liver cancer death rate (simple correla...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(88)90165-5
更新日期:1988-01-01 00:00:00
abstract::We develop a stochastic model of screening for ovarian cancer with serum levels of the CA 125 radioimmunoassay, a tumor-specific marker. The natural history of the disease is constructed using a four stage model characterized by a multivariate distribution for duration in each stage. Preserving its important features,...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90075-k
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of weight-loss interventions on health-related quality of life (HrQoL) in randomized controlled trials (RCTs); to conduct a meta-analysis of weight-loss treatment on depressive symptoms; and, to examine methodological and presentation issues that compromise study validity. STUDY DESIGN...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jclinepi.2004.10.015
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to consider statistical and methodological issues affecting the results of meta-analysis of genetic association studies for pertinent gene-disease associations. Although the basic statistical issues for performing meta-analysis are well described in the literature, there are remaining...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2007.12.011
更新日期:2008-07-01 00:00:00
abstract::Seasonal plasma lipid and lipoprotein cycles were studied in 1446 hypercholesterolemic 35-59 year-old men followed for 7 years as the placebo group of the Lipid Research Clinics (LRC) Coronary Primary Prevention Trial (CPPT). Separate periodic time series were calculated for each study participant; mean parameter esti...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0895-4356(88)90120-5
更新日期:1988-01-01 00:00:00
abstract::Measurement of physical activity in epidemiological studies is usually achieved by means of a questionnaire. Little work has been done to determine which questionnaire format has greater validity in an elderly population. In this study of elderly subjects, physical activity as reported in two self-administered questio...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(92)90071-t
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVES:The objective of the study was to describe and compare current practices in developing guidelines about the use of healthcare-related tests and diagnostic strategies (HCTDS). STUDY DESIGN AND SETTING:We sampled 37 public health and clinical practice guidelines about HCTDS from various sources without langua...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2017.09.004
更新日期:2017-12-01 00:00:00
abstract::The associations between nine domain-specific measures of health (e.g., depressive symptoms, psychological distress, mental health, physical functioning, role functioning, social functioning, bodily pain, somatic symptoms, and chronic medical morbidity) and a single-item measure for perceived overall health were studi...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(97)00234-5
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To determine whether zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in the treatment of acute diarrhea. STUDY DESIGN AND SETTING:Cost-effectiveness analysis among patients consulting the emergency room of a government institution. METHOD:Cost of treatment and outcome of part...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinepi.2006.08.004
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:The relative contributions of genetic and environmental variables to within-household clustering of quantitative traits in household surveys are poorly characterized. We estimated shared genetic and shared environmental contributions to within-household correlation for anthropometric variables and cardiovasc...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.02.015
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:A method to generate hypotheses about iatrogenic risk factors and complications from administrative data was developed and tested using hospitalization of the elderly for depression as a model. STUDY DESIGN AND SETTING:Hospital claims were selected for 30,998 elderly inpatients admitted for the first time fo...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.08.002
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:A comprehensive picture of population health status can be captured by the incorporation of patient-reported outcome measures into population health monitoring. OBJECTIVE:The aim of the study was to identify the current state, opportunities, and future research related to the utilization of patient-reported...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.04.018
更新日期:2017-09-01 00:00:00
abstract::Comparison of psychosocial adjustment in women with breast cancer (BC) and women with benign breast problems (BBP) has been hampered by a failure to control for age differences between these groups, as well as a failure to assess positive psychosocial adaptation in addition to psychological distress. Age-matched women...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(96)00028-5
更新日期:1996-08-01 00:00:00
abstract::The objective of the study was to determine the sensitivity and specificity of the National Cholesterol Education Program (NCEP) guidelines in identifying at-risk individuals for hypercholesterolemia, using population-based data from the Manitoba Heart Health Survey (MHHS). The MHHS surveyed a representative sample of...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)90301-8
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:To review James Jackson's analysis of bloodletting among pneumonitis patients at the newly founded Massachusetts General Hospital, in which he implemented the numerical method advocated by Pierre-Charles-Alexandre Louis. STUDY DESIGN AND SETTING:The study sample included 34 cases of clinically diagnosed pne...
journal_title:Journal of clinical epidemiology
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.jclinepi.2014.10.013
更新日期:2015-04-01 00:00:00
abstract::Pierre Charles Alexandre Louis (1787-1872) has been the direct or indirect mentor of influential U.S. and English scientists in public health, epidemiology, medicine, and biostatistics during the 19th and 20th century. Louis was primarily a clinician, but his name has been more closely associated with the history of e...
journal_title:Journal of clinical epidemiology
pub_type: 传,历史文章,杂志文章
doi:10.1016/s0895-4356(96)00294-6
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:This study investigates how voluntary changes in tobacco consumption are related to changes in biological risk factors for cardiovascular disease in 21- to 36-year-old men and women. STUDY DESIGN AND SETTING:Data of the Amsterdam Growth and Health Longitudinal Study (AGAHLS) were used to study the associatio...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2005.02.019
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:To assess differences between three different decision-making approaches in the method of panel diagnosis as reference standard in diagnostic research. STUDY DESIGN AND SETTING:Within a diagnostic study, the prevalence of heart failure (HF) and chronic obstructive pulmonary disease (COPD) was compared using...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2014.09.020
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To describe the pain decrease considered as clinically relevant when designing a trial and reporting its results. METHODS:A systematic review of the literature in MEDLINE was conducted to select randomized controlled trials (RCTs) with pain as a primary outcome. Data extracted included the definition (terms ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.06.008
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:To evaluate how the rank probabilities obtained from network meta-analysis (NMA) change with the use of increasingly stringent criteria for the relative effect comparing two treatments which ranks one treatment better than the other. STUDY DESIGN AND SETTING:Systematic survey and reanalysis of published dat...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.02.008
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:This study estimated the inter- and intraobserver reliability of a set of noninstrumented physical examination measures for knee pain in older adults. STUDY DESIGN AND SETTING:Forty-five patients from primary care, and 13 patients from secondary care, were each examined by two out of a team of three physical...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2005.11.004
更新日期:2006-05-01 00:00:00
abstract::A literature search identified eight articles containing data on both baldness and coronary artery disease (CAD). Three of these articles described case-control studies that showed a positive relationship between baldness and CAD when controlling for CAD risk factors. Three other case-control studies showed no such re...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/0895-4356(90)90026-l
更新日期:1990-01-01 00:00:00