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Harvesting Knowledge From Improvement
Donald M. Berwick, MD
JAMA. 1996;275(11):877-878.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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Among the important gains in health care in this quarter-century has been the progress of disciplined statistical methods for clinical research. Thanks to leaders like Sir Richard Doll, J. N. Morris, Kerr White, Alvan Feinstein, Frederick Mosteller, Thomas Chalmers, David Sackett, and others, clinical investigators today use more sophisticated approaches to inference, and readers of their reports are more able to judge the soundness of experimental design. The randomized clinical trial (RCT) has emerged for good reason as the prince of designs, and we also understand better the proper use of case-control, cohort, and quasi-experimental studies.
See also p 841.
These new standards have reached the mainstream. Journal reviewers demand evidence of proper control and statistical analyses. Study sections attend carefully to details of proposed methods, like sample size calculations, randomization rules, and investigator blinding. Of the first 50 original scientific reports in the New England Journal of Medicine in
. . . [Full Text PDF of this Article]
Author Affiliations
From the Institute for Healthcare Improvement, Boston,Mass.
Footnotes
Reprint requests to Institute for Healthcare Improvement, 135 Francis St, Boston, MA 02215 (Dr Berwick).
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