Abstract
In the early years of the 21st century, clinicians and medical researchers often use the term evidence-based medicine. Cancer prevention, screening, diagnosis, and therapy, we hear, must be based on the best evidence to provide the best care. But is this approach new? And if it is, what have we been doing until now? In this chapter, we hope to provide perspectives on this question, by examining what evidence-based medicine (EBM)—oncology, in particular—is and is not, and by looking at the history of clinical inquiry, up to and including current research. We also hope to provide readers with a theoretical framework that will be useful in placing the results of new research into the context of existing knowledge, with the ultimate goal of improving clinical practice.
The opinions expressed in this manuscript are those of the authors and do not represent official opinions or positions of the National Institutes of Health, the Department of Health and Human Services, or the federal government.
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References
Evidence-Based Medicine Working Group. Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA 1992;268:2420–2425.
Sackett D, Straus SE, Richardson WS, et al. Evidence-Based Medicine: How to Practice and Teach Evidence-Based Medicine. Edinburgh: Churchill Livingston, 2000.
Morabia A. P.C.A. Louis and the birth of clinical epidemiology. J Clin Epidemiol 1996:49:1327–1333.
Dunn PM. James Lind (1716–94) of Edinburgh and the treatment of scurvy. Arch Dis Childhood 1997;76:F64–F65.
Keith JM. Florence Nightingale: statistician and consultant epidemiologist. Int Nurs Rev 1988;35:147–150.
Gehan E. The role of the biostatistician in cancer research. Biomed Pharmacother 2001;55:502–509.
Mainland D. The rise of experimental statistics and the problems of a medical statistician. Yale J Biol Med 1954;27:1–10.
Meldrum ML. A brief history of the randomized clinical trial: from oranges and lemons to the gold standard. In: Allegra CJ, Kramer BS (eds). Hematology/Oncology Clinics of North America: Understanding Clinical Trials. Philadelphia: Saunders, 2000.
Fisher B, Bauer M, Margolese R, et al. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med 1985;312:665–673.
Centre for Evidence-Based Medicine, http://www.cebm.utoronto.ca/practise/formulate/.
Albanes D, Heinonen OP, Taylor PR et al. α-Tocopherol and β-carotene supplements and lung cancer incidence in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study: effects of base-line characteristics and study compliance. J Natl Cancer Inst 1996;88:1560–1570.
Krieger N, Wolff MS, Hiatt RA, et al. Breast cancer and serum organochlorines: a prospective study among white, black, and Asian women. J Natl Cancer Inst 1994;86(8):589–599.
Fisher B. Clinical trials for the evaluation of cancer therapy. Cancer (Phila) 1984;54:2609–2617.
Roussouw JE, Anderson GL, Prentice RL et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized clinical trial. JAMA 2002;288:321–333.
Dans AL, Dans LF, Guyatt GH, et al. Users’ guides to the medical literature: XIV. How to decide on the applicability of clinical trial results to your patient. Evidence-Based Medicine Working Group. JAMA 1998;279:545–549.
McAlister FA, Straus SE, Guyatt GH et al. Users’ guides to the medical literature. XX. Integrating research evidence with the care of the individual patient. JAMA 2000;283:2829–2836.
Feuer EJ, Frey CM, Brawley OW, et al. After a treatment breakthrough: a comparison of trial and population-based data for advanced testicular cancer. J Clin Oncol 1994;12:368–377.
Nattinger AB, Hoffmann RG, Howell-Pelz A, et al.. Effect of Nancy Reagan’s mastectomy on choice of surgery for breast cancer by U.S. women. JAMA 1998;279:762–766.
Weir HK, Thun MJ, Hankey BF, et al. Annual report to the Nation on the status of cancer, 1975–2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Cancer Inst 2003;95:1276–1299.
Welch HG, Schwartz SM, Woloshin S. Are increasing 5-year survival rates evidence of success against cancer? JAMA 2000;283:2975–2978.
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© 2006 Springer Science+Business Media, Inc.
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DeVoto, E., Kramer, B.S. (2006). Evidence-Based Approach to Oncology. In: Chang, A.E., et al. Oncology. Springer, New York, NY. https://doi.org/10.1007/0-387-31056-8_1
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DOI: https://doi.org/10.1007/0-387-31056-8_1
Publisher Name: Springer, New York, NY
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