International journal of technology assessment in health care
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Int J Technol Assess Health Care · Jan 1990
Biography Historical ArticleErnest Amory Codman, M.D., and end results of medical care.
Ernest Amory Codman, M. D., was one of the most important figures in the history of outcomes research in medicine. While his contemporaries scorned his efforts to create systematic procedures to evaluate the end results of medical care, his work foreshadowed many of today's most pressing issues in technology assessment. This article traces Codman's career as an innovator and political gadfly at the Massachusetts General Hospital during the first three decades of this century, and examines the development and demise of his end-result system.
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Int J Technol Assess Health Care · Jan 1989
Review Comparative StudyPragmatic versus explanatory trials.
This article considers the distinction between "explanatory" and "pragmatic" aims in clinical trials--the distinction between testing a biological hypothesis and providing evidence to permit a choice between alternative treatment policies. The choice of treatments to compare, the selection of patients for the trial, the study size, and how the treatment comparison should be made are among the matters discussed. In general, where explanatory and pragmatic aims conflict, the pragmatic aim will often take priority.
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Int J Technol Assess Health Care · Jan 1989
Review Randomized Controlled Trial Clinical TrialNonexperimental data systems in surgery.
This article reviews nonexperimental data bases, emphasizing the present uses and future opportunities of routinely collected information. Data bases are discussed in terms of appropriate research designs. Possibilities for expanding available information through new data collection and through record linkage are stressed. The relationship of nonexperimental data systems to randomized trials and to clinical decision-making is examined.