1. A. Cochrane Effectiveness and Efficiency, p. 1
“In the 1930’s the idea of a National Health Service (NHS) was not then the source of my greatest enthusiasm. Anti-fascist activities (and in particular Spain) headed the list, but the NHS ranked high.”
A. Cochrane
Effectiveness and Efficiency, p. 1

2. Clinical Epidemiological FIGURE 5.2. Clinical and
epidemiological interpretations
of distributions of quantitative
biological characteristics
Clinical
Characteristic measured
Epidemiological
Characteristic measured

3. Efectividad: Efecto de una actuación médica en alterar la historia natural de la enfermedad (entendidos como los resultados de investigación, en lugar de los resultados obtenidos en la práctica clínica rutinaria).
Eficiencia: El uso óptimo de personal y materiales para obtener estos efectos.
Equidad: Diferencias en el cuidado médico entre ricos y pobres.

4. FIGURE 1. The relationship between evidence-based medicine and
patient-centred medicine
Information of
importance to patient
choice which is not even
potentially of evidence-based
type. E.g. Information about
the process of delivery of
health care
Area where there is currently good
evidence-based information which is of
importance to patients in making choices C A B
Information of importance to
patient choice which is potentially
of evidence-based type
A Information which is currently based on good evidence
B Information for which good quality evidence-based information could be available
in due course
C Information which is potentially of importance to patients in making health care
choices
Source: Hope T. ‘Evidence-based patient choice and the doctor-patient relationship’.
In: But Will it Work, Doctor? Kings Fund, London 1997,

5. A. Cochrane Effectiveness and Efficiency, p. 7
“I believe that cure is rare while the need of care is widespread and that the pursuit of cure at all costs may restrict the supply of care, but the bias has at least been declared.”
A. Cochrane
Effectiveness and Efficiency, p. 7

6. A. Cochrane Effectiveness and Efficiency, p. 43
“I was brought up in an older tradition. I was told “before ordering a test decide what you will do if it is a) positive, or b) negative, and if both answers are the same don’t do the test. At the other end of the scale is the most recent innovation whereby a package of results of a dozen tests arrive at the bedside almost before the signs and symptoms have been elicited.
A. Cochrane
Effectiveness and Efficiency, p. 43

7. Julian Tudor Hart Lancet 1971; i: 405
The inverse care law “The availability of good medical care tends to vary inversely with the need for it in the population served”
Julian Tudor Hart
Lancet 1971; i: 405