Arun D. Singh Bertil E. Damato Editors

Basic Principles

Fourth Edition

Editors

Basic Principles

Fourth Edition

Editors

Arun D. Singh

Department of Ophthalmic Oncology

Cleveland, OH, USA

Bertil E. Damato

Ocular Oncology Service

London, UK

ISBN 978-3-031-75906-2 ISBN 978-3-031-75907-9 (eBook)

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During the last decade, evidence-based medicine (EBM) has become a dominant approach in many medical fields, including ophthalmology [1, 2]. Clinical epidemiological studies provide evidence that can aid decision-making processes. An overwhelming amount of clinical epidemiological papers are being published every year, and critical appraisal of the findings can be challenging, especially for the busy clinician who is not formally trained in the field of clinical epidemiology. Therefore, the available evidence is increasingly bundled in clinical guidelines. The aim of this chapter is to provide readers with some basic knowledge to allow them to judge the value of clinical epidemiological papers and, thus, the pillars of evidence-based clinical guidelines. Examples from ocular oncology will be used to illustrate the methodological principles.

A clinical epidemiological study should always start with a well-defined research question. Similarly, when reading a paper, one should always first identify the question(s) the authors wish to address (Fig. 1.1). Research questions can be aimed at explanation or description. Explanatory research examines causal relationships, while descriptive research is merely descriptive. In addition, research questions are also often categorized as etiological, diagnostic, or prognostic (Table 1.1). For example, an explanatory research question related to etiology in the field of ocular oncology is as follows: are children born after in vitro fertilization at higher risk of developing retinoblastoma as compared to children born after natural conception? [3] A correct explanatory research question should contain information on the patients, interventions, contrast, and outcomes (PICO) at issue.