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The author of this book can be described as the father of modern epidemiology. Here he exposes the untenability of the prevailing teachings about clinical epidemiology and EBM, and advances a vision of major improvements in clinical medicine.

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´Clinical epidemiology´ is now widely promoted and taught as a ´basic science´ of Evidence-Based Medicine, of clinical EBM to be specific. This book, however, is mostly about that which Miettinen takes to be the necessary substitute for this now-so-fashionable subject - namely, Theory of Clinical Medicine together with its subordinate Theory of Clinical Research.

The leit motif in all of this is Miettinen´s perception of the need, and opportunity, to bring major improvements into clinical medicine in this Information Age, now that theoretical progress has made feasible the development of practice-guiding Expert Systems for it.

Parts of this text constitute essential reading for whoever is expected, or otherwise inclined, to study - or teach - ´clinical epidemiology,´ and the same is true of those who set policy for the education of future clinicians; but practically all of it is essential reading for future - and current - academics in the various disciplines of clinical medicine. After all, the text is the result of a concentrated effort, over a half-century no less, to really understand both clinical and community medicine and the research to advance the knowledge-base of these. Research epidemiologists, too, will find this text interesting and instructive.

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Acknowledgements. Foreword. Preface. Aims of the course. Abstracts. PART I. PRELIMINARIES. I - 1. ON LEADERSHIP IN CLINICAL MEDICINE. I - 2.ON MEDICAL ACADEMIA AT PRESENT.I -3. PURPORTED ESSENCE OF CLINICAL RESEARCH.I - 4.ON STUDY OF ´CLINICAL EPIDEMIOLOGY´.I - 5. UP FROM ´CLINICAL EPIDEMIOLOGY´ AND EBM. PART II. THEORY OF CLINICAL MEDICINE. II - 1. THE KNOWLEDGE-BASE OF CLINICAL MEDICINE: ITS ESSENCE. II - 2. THE KNOWLEDGE-BASE OF CLINICAL MEDICINE: ITS NECESSARY FORMS. II - 3.CODIFYING THE KNOWLEDGE-BASE OF EXPERT PRACTICE. PART III. THEORY OF CLINICAL RESEARCH. III - 1.ENHANCEMENT OF PRACTICE BY CLINICAL RESEARCH. III - 2.INTRODUCTION INTO DIAGNOSTIC CLINICAL RESEARCH.III - 3.INTRODUCTION INTO ETIOGNOSTIC CLINICAL RESEARCH. III - 4. INTRODUCTION INTO PROGNOSTIC CLINICAL RESEARCH. PART IV. CONTEMPORARY REALITIES IN CLINICAL RESEARCH. IV - 1. ON EBM GUIDELINES FOR ASSESSMENT OF EVIDENCE. IV - 2. SOME EXAMPLE STUDIES: THEIR ASSESSMENTS. PART V. EPILOGUE ON MAJOR IMPROVEMENTS IN CLINICAL MEDICINE. V - 1. THE PREDICATES OF MAJOR IMPROVEMENTS. V - 2. DEVELOPMENT OF THE MAJOR IMPROVEMENTS. V - 3.RESEARCH FOR FURTHER IMPROVEMENTS. V - 4.´CLINICAL EPIDEMIOLOGY´ AND EBM AS SET-BACKS. Appendices.

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