Getting doctors to listen : ethics and outcomes data in context /

This edited volume explores medical outcomes research and the development of, and sources of resistance to, clinical guidelines. Introductory chapters provide an overview of policy and philosophical issues, explore the recent history of medical technology assessment, and recapitulate sources of medical antipathy to clinical guidelines. Seven central chapters explore the way in which outcomes research is conducted, the methodologies and problems of guideline development, and issues and strategies in implementing guidelines. Of particular note are chapters by Bell (hormone therapy) and Kelly and Koenig (innovative therapies for metastatic breast cancer), which provide detailed clinical examples while also addressing underlying philosophical and practical issues in assessment and guideline development. The book's final section is composed of four chapters that explicitly address the inevitable interplay of values and data in science, in clinical care, and in the development of evidence-based medicine. Because many chapters are abstract and assume some background in philosophy, the book may not be easily accessible to general readers or students in the health sciences. However, it should be of considerable value to bioethicists and to health care managers who must implement clinical guidelines. Faculty; professionals. L. A. Crandall; University of Illinois at Urbana-Champaign