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The third edition of this book was published in 2013: that's seven years ago! We are thankful that all of the previous editions were so well liked, and that we received so many favourable comments from readers. But seven years is a long time and we have felt for a while that the book needed refreshing to take into account readers’ suggestions and our own feelings about the potential for improvements. As a consequence, this fourth edition has been extensively revised and extended. The changes include four completely new chapters:

 Studies of Complex Interventions.

 Systematic Review of Qualitative Studies.

 Research Using Already‐Collected Data. This new chapter will include material on missing data, confounding by indication, and other relevant topics.

 Poisson Regression.

At the same time every other chapter has been extensively revised, and with much new material added, on, for example, the difference between clinical and statistical significance; reservations about the p‐value; the consequences of multiple testing and methods of correction; nested case–control studies; feasibility and pilot studies; cluster randomized trials; stratified random allocation; adaptive trial designs; sub‐group analysis; standardized guidelines for writing trials and reviews; and much more. In addition, we have improved the text throughout where we thought this would lead to better understanding. Importantly, we have also updated a great many of the examples from the literature.

As before, this edition of our book should appeal to all of those professionals involved in clinical work who wish to improve their understanding of the research literature.

David Bowers, Allan House, David Owens, and Bridgette Bewick

Leeds 2020