Hematology/oncology clinics of North America
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In 1992, a review article about meta-analysis identified only 15 meta-analyses of randomized, controlled trials of cancer therapy. Since then, the total number of meta-analyses in this field has increased almost sixfold. More importantly, the number of randomized, controlled trials in this discipline has also grown tremendously. ⋯ Several examples of their application are already available in oncology. Meta-analysis may point out deficiencies in the study design of past and current studies, suggest the need for new studies, and inform researchers about the size and design of these studies. In the end, meta-analysis helps to integrate evidence and make recommendations for medical care and medical practice.
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Hematol. Oncol. Clin. North Am. · Aug 2000
ReviewEvidence-based medicine. Interpreting studies and setting policy.
The ascendancy of EBM has been accompanied by a greater awareness of its shortcomings. It is increasingly evident from the cost, length, and difficulty of performing RCTs that studies cannot be launched to address every question in medicine. Good evidence is often lacking in medicine. ⋯ Tools such as reminder systems, standing orders, academic detailing, peer review and audit, feedback, and health system changes recognize that knowing what to do is only one piece of an increasingly complex puzzle. The competitive marketplace of managed health care has added new economic influences on clinician behavior but is also fueling private-sector interest in good research. Patients, clinicians, and policy makers will continue to seek better data concerning what works in medicine and what does not.
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Hematol. Oncol. Clin. North Am. · Aug 2000
ReviewThe importance of quality-of-life endpoints in clinical trials to the practicing oncologist.
Quality-of-life research has helped describe and draw attention to the human side of cancer treatment. The field has made tremendous advances and has influenced the treatment of cancer. The practicing oncologist can benefit greatly by keeping abreast of developments in this field and applying them to the selection of treatment modalities based on both treatment efficacy and the patient's wishes. In the future, quality-of-life research will probably continue to be integrated into the practice of oncology.