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October 11, 1985

Clinical Epidemiology: The Architecture of Clinical Research

Author Affiliations

Summit, NJ

JAMA. 1985;254(14):1997. doi:10.1001/jama.1985.03360140159045

Some years ago, I read, with growing enthusiasm, Clinical Judgment, Alvan Feinstein's defense of the scientific validity of clinical medicine and clinical opinions. Written in an era during which the grants for basic and clinical research threatened to make second-class citizens of those physicians who saw patients, this tour de force legitimized clinical practice. Now, the same author is back, with a massive tome that applies Occam's razor to clinical experimentation. His new book defines the terms, sets the limitations, hones the critical judgment, and firmly bases the fundamentals for those who would conduct clinical research, judge it, or read about it.

This massive book painstakingly examines and defines all the concepts that underlie clinical decisions. It presents the statistical background for judgments. It permits the reader to analyze studies in journals and is thus essential for those who would design their own prospective or retrospective studies. It points out