Milos Jenicek

Evidence and its uses in health care and research: The role of critical thinking

Summary Obtaining and critically appraising evidence is clearly not enough to make better decisions in clinical care. The evidence should be linked to the clinician’s expertise, the patient’s individual circumstances (including values and preferences), and clinical context and settings. We propose critical thinking and decision-making as the tools for making that link. Critical thinking is also called for in medical research and medical writing, especially where pre-canned methodologies are not enough. It is also involved in our exchanges of ideas at floor rounds, grand rounds and case discussions; our communications with patients and lay stakeholders in health care; and our writing of research papers, grant applications and grant reviews. Critical thinking is a learned process which benefits from teaching and guided practice like any discipline in health sciences. Training in critical thinking should be a part or a pre-requisite of the medical curriculum.

Meta-analyse en medecine: the first book on systematic reviews in medicine

Interest in systematic reviews and meta-analysis in medicine began in the late 1970s. During the 1980s, these methods began to be adopted more widely by medical researchers, and in the late 1980s, expository journal articles began to appear, and the first book about meta-analysis in medicine was published. The book was published in 1987 by Milos Jenicek, a professor at the Universite de Montreal. Too often, the anglophone world remains unaware of important contributions to science and other fields which have been published in languages other than English. So it was with this book, which was published in French. A bilingual friend – Michael Kramer, a professor of epidemiology at McGill University in Montreal – obtained a copy of the book for me in 1994. After reading and greatly enjoying it, I visited Montreal in October of that year and asked Milos to sign my copy. He wrote: ‘To Dr Iain Chalmers, with compliments and astonishment that he still believes that this book is worth reading’. Meta-analyse en medecine was and remains wellworth reading, even for someone whose knowledge of French is not very strong. I regard the book as an important and insufficiently acknowledged milestone in the development of methods to assess the effects of medical treatments. Even if I or others had cited the book appropriately, however, it would have been difficult and probably impossible for our readers to have accessed copies of it, as its stock was shredded by the publisher not all that long after it had been published. It is for this reason that fairly long excerpts from the book, with translations, have been added to the James Lind Library. Because of the importance of the book in the history of research synthesis in medicine, I wanted to find out from Milos Jenicek how he came to write it. What follows takes the form of an interview, although it is not a verbatim account of our conversations and communications. IC: How far back does one have to go to identify the origins of the ideas that led to the book?

Evidence-based public health

Within the recent outburst of “evidence-based” books covering now many medical specialties, this book is another welcome newcomer. Authors have chosen rightly for this first evidence-based public health (EBPH) book a methodological introduction, rather than the evidence-based coverage of particular problems in public health. The message addresses a large readership with many recalls to basic notions from epidemiology, biostatistics, and other foundations of EBPH. This is wise, because many …