Controlled Clinical Trials in Neurological Disease

✍ Scribed by John F. Kurtzke (auth.), Roger J. Porter, Bruce S. Schoenberg (eds.)

• Publisher: Springer US
• Year: 1990
• Tongue: English
• Leaves: 446
• Series: Foundations of Neurology 1
• Edition: 1
• Category: Library

✦ Synopsis

The evaluation of the efficacy and safety of a clinical tool, be it a diagnostic technique, a preventive methodology, or a therapeutic intervention, is an im­ portant responsibility of physicians. The history of medicine is characterized by the authoritarianisms of teachers and of organizations giving way to the clinical experience of physicians; authoritarian dictum was replaced by case report and then by case series. As physicians learned to substitute the analysis of data for the inconsistencies of dictums and anecdotes, the problems of the case series as an investigative tool became more evident: patient selection criteria, measurements of outcome, significance of results, and extrapolation of conclusions to the community of patients. In response to these issues, the methodology of the controlled clinical trial has evolved and with it the instru­ ments of study design and of biostatistics as aids to study design and data analysis. The medical - surgical armamentarium has evolved from being dependent solely upon the observations and conclusions of a skilled clinician to being constructed upon the systematic collection and evaluation of data by a team of skilled clinicians and their statistical colleagues: this is the controlled clinical trial. During the past two decades, the evaluation of clinical approaches to pre­ vention and therapy has become particularly important to clinicians concerned with nervous system dysfunction. There has been and continues to be an explosion of information from the basic neurosciences and from the applica­ tion of biotechnology to the nervous system.

✦ Table of Contents

Front Matter....Pages i-xxiii
Front Matter....Pages 1-1
Clinical Considerations....Pages 3-16
Initial Statistical Considerations....Pages 17-27
Statistical and Epidemiological Considerations....Pages 29-51
Front Matter....Pages 53-53
Perspective of the Patient....Pages 55-62
Perspective of the Participating Investigator....Pages 63-68
Perspective of the Clinical Center....Pages 69-76
Perspective of the Coordinating Center....Pages 77-83
Perspective of the Food and Drug Administration....Pages 85-96
Perspective of the Pharmaceutical Industry....Pages 97-104
Perspective of the Insurance Industry....Pages 105-110
Front Matter....Pages 111-111
Cerebrovascular Disease....Pages 113-132
Epilepsy....Pages 133-155
Movement Disorders....Pages 157-170
Head and Spinal Cord Injury....Pages 171-183
Headache....Pages 185-201
Peripheral Neuropathy....Pages 203-224
Guillain-Barré: Plasmapheresis....Pages 225-247
Motor Neuron Disease....Pages 249-281
Myasthenia Gravis....Pages 283-304
Muscular Dystrophy....Pages 305-319
Front Matter....Pages 111-111
Multiple Sclerosis....Pages 321-341
Brain Tumors....Pages 343-360
Alzheimer’s Disease....Pages 361-391
Viral Diseases: Herpes Simplex Encephalitis....Pages 393-406
Parasitic Diseases....Pages 407-424
Back Matter....Pages 425-440

✦ Subjects

Neurology; Neurosciences