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It is a thought-provoking book that addresses foundational issues and advocates non-standard statistical procedures specially tailored to answer biological and medical questions of interest. Such specially tailored procedures have not been used much in practice until now because of computational difficulties. However, with the advent and ready availability of high speed desktop computers, that should no longer be a deterrence. The author brings his years of experience with clinical trials to illustrate his approach with a diverse variety of examples.   The centraltheme of the book is that, as a first step, careful thought must be given to how the treatment is expected to affect the patient response, to postulate a suitable model that reflects this mechanism and specify a restricted alternative hypothesis on the parameters of the model. One can then use Neyman's theory of restricted tests to construct an overall test that is powerful against the specified alternative hupothesis. 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