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Evidence-based Practice in Primary Care
Mayo Clio Proc, December 1999, Vol 74
Principles and Practice of Pediatric Neurosurgery, edited by A. Leland Albright, Ian F. Pollack, and P. David Adelson, 1300 pp, with illus, $239, New York, NY, Thieme Medical Publishers (telephone: 800-782-3488), 1999, ISBN 0-86577-799-3
Type of Book: A multiauthored comprehensive review of neurologic disorders that occur in the pediatric age-group. Scope of Book: Numerous internationally recognized experts discuss the diagnosis of various disorders affecting pediatric patients, associated treatment options, and outcomes. Contents: This 69-chapter text is divided into 8 sections devoted to the following topics: examination, congenital and developmental abnormalities, neoplasms, trauma, cerebrovascular diseases, functional disorders, infection, and anesthetic considerations in the pediatric population. The chapters nicely summarize areas of both consensus and controversy. The editors' comments at the end of each chapter are helpful, and the authors' lists of "pearls" should serve as a useful guide for trainees preparing for the various examinations during the course of their neurosurgical pursuits. Although much of the information presented is basic to practicing neurosurgeons, every chapter contained some information that enhanced my understanding of the subject being discussed. Strengths: In general, the authors are recognized authorities on the subjects they review. The text is well organized, contains a wealth of information, and has extensive lists of references after each chapter. Deficiencies: Although I noted no major deficiencies in the volume, I personally prefer that references be listed in alphabetical order rather than the system of order of occurrence in the text that is used in this book. Recommended Readership: This is a good reference book for practicing neurosurgeons, pediatricians, and pediatric neurologists. It would also serve as a great study guide for neurosurgery residents, including pediatric neurosurgical fellows. Overall Grading:
*****
Michael J. Ebersold, MD, Department of Neurologic Surgery, Mayo Clinic Rochester, Rochester, Minn
Evidence-based Practice in Primary Care, edited by Leone Ridsdale, 199 pp, with illus, $29.95, New York, NY, Churchill Livingstone (telephone: 800-545-2522), 1998, ISBN 0-44305889-X
Type ofBook: A multiauthored book about evidence-based medicine (EBM) in primary care, written by general practitioners. Scope of Book: This book is intended to be a self-teaching guide to the application of EBM principles in primary care using a problem-based approach. Contents: The book consists of 10 chapters. Chapter 1 defines EBM in a primary care context. Question formulation and searching medical databases are addressed in chapter 2. Chapters 3 through 9 demonstrate the critical appraisal of articles (reprints included) on therapy, diagnosis, overviews, and prognosis. They also cover qualitative research, practice guidelines, and clinical audits, topics that are extremely pertinent to primary care. Chap-
Book Reviews
1309
ter 10 focuses on teaching and learning EBM. The authors provide EBM resources that are available in the United Kingdom and complete the book with a glossary of terms used in therapeutics. All chapters are adequately referenced. Strengths: This book differs from others on EBM by its emphasis on qualitative research and in its use of primary care problems (ie, back pain, asthma, and diabetes) to illustrate EBM principles. The chapters on diagnosis and overviews are particularly strong. Deficiencies: The chapter on searching ignores methodological filters and describes an inefficient and time-consuming process that is inappropriate for busy clinicians. The chapter on therapy makes incorrect judgments about the validity of the article cited and deviates from convention regarding number-needed-to-treat A discussion on the incorporation of patients' and caregivers' preferences into clinical decision making would have been useful. Recommended Readership: Primary care physicians, particularly in the United Kingdom. A better book on evidence-based medicine in primary care for a wider audience is the text by the same title edited by Silagy and Haines (BMJ Publishing Group, 1998, ISBN 0-7279-1210-0). Overall Grading:
**
Victor M. Montori, MD, Department of Internal Medicine, Mayo Clinic Rochester, Rochester, Minn
Instructions for Surgery Patients, by Steven G. Economou and Tasia S. Economou, 720 pp, with illus, $69, Philadelphia, Pa, W. B. Saunders Company (telephone: 800-545-2522), 1999, ISBN 07216-7188-8
Type ofBook: Patient information. Scope of Book: This book of patient hand-outs provides broad coverage of surgical procedures and diseases. Contents: This compendium of take-home instructions and information for surgical patients is organized into 1- or 2-page missives, generally presented in nontechnical language. The book covers several surgical specialties and is accompanied by a CDROM containing the entire book. Presumably, the surgeon prints out the appropriate section or sections and presents it to the patient as a hand-out. Simple line drawings accompany some of the discussions. Each entry is organized into general information, common signs and symptoms, diagnosis, surgical treatment, postoperative care, home care, and "call our office if' lists. Strengths: This text represents a starting point for information to share with patients. The accompanying CD-ROM provides printed pages quickly and easily. Deficiencies: The alphabetically arranged entries are somewhat confusing-some entries are diseases and others are procedures. To confuse matters further, the headings are in "patient-friendly" language rather than standard medical terminology, with no cross-referencing other than the index. This mixture of lay and medical language extends to the text as well. In addition, the copyrighted forms can be printed from the CD-ROM only as they appear in the text, despite the fact that the authors' postoperative regimens likely differ in varying degrees from other surgeons' management strategies. Topics of general interest, such as inci-
For personal use. Mass reproduce only with permission from Mayo Clinic Proceedings.
Principles and Practice of Pediatric Neurosurgery, edited by A. Leland Albright, Ian F. Pollack, and P. David Adelson, 1300 pp, with illus, $239, New York, NY, Thieme Medical Publishers (telephone: 800-782-3488), 1999, ISBN 0-86577-799-3
Type of Book: A multiauthored comprehensive review of neurologic disorders that occur in the pediatric age-group. Scope of Book: Numerous internationally recognized experts discuss the diagnosis of various disorders affecting pediatric patients, associated treatment options, and outcomes. Contents: This 69-chapter text is divided into 8 sections devoted to the following topics: examination, congenital and developmental abnormalities, neoplasms, trauma, cerebrovascular diseases, functional disorders, infection, and anesthetic considerations in the pediatric population. The chapters nicely summarize areas of both consensus and controversy. The editors' comments at the end of each chapter are helpful, and the authors' lists of "pearls" should serve as a useful guide for trainees preparing for the various examinations during the course of their neurosurgical pursuits. Although much of the information presented is basic to practicing neurosurgeons, every chapter contained some information that enhanced my understanding of the subject being discussed. Strengths: In general, the authors are recognized authorities on the subjects they review. The text is well organized, contains a wealth of information, and has extensive lists of references after each chapter. Deficiencies: Although I noted no major deficiencies in the volume, I personally prefer that references be listed in alphabetical order rather than the system of order of occurrence in the text that is used in this book. Recommended Readership: This is a good reference book for practicing neurosurgeons, pediatricians, and pediatric neurologists. It would also serve as a great study guide for neurosurgery residents, including pediatric neurosurgical fellows. Overall Grading:
*****
Michael J. Ebersold, MD, Department of Neurologic Surgery, Mayo Clinic Rochester, Rochester, Minn
Evidence-based Practice in Primary Care, edited by Leone Ridsdale, 199 pp, with illus, $29.95, New York, NY, Churchill Livingstone (telephone: 800-545-2522), 1998, ISBN 0-44305889-X
Type ofBook: A multiauthored book about evidence-based medicine (EBM) in primary care, written by general practitioners. Scope of Book: This book is intended to be a self-teaching guide to the application of EBM principles in primary care using a problem-based approach. Contents: The book consists of 10 chapters. Chapter 1 defines EBM in a primary care context. Question formulation and searching medical databases are addressed in chapter 2. Chapters 3 through 9 demonstrate the critical appraisal of articles (reprints included) on therapy, diagnosis, overviews, and prognosis. They also cover qualitative research, practice guidelines, and clinical audits, topics that are extremely pertinent to primary care. Chap-
Book Reviews
1309
ter 10 focuses on teaching and learning EBM. The authors provide EBM resources that are available in the United Kingdom and complete the book with a glossary of terms used in therapeutics. All chapters are adequately referenced. Strengths: This book differs from others on EBM by its emphasis on qualitative research and in its use of primary care problems (ie, back pain, asthma, and diabetes) to illustrate EBM principles. The chapters on diagnosis and overviews are particularly strong. Deficiencies: The chapter on searching ignores methodological filters and describes an inefficient and time-consuming process that is inappropriate for busy clinicians. The chapter on therapy makes incorrect judgments about the validity of the article cited and deviates from convention regarding number-needed-to-treat A discussion on the incorporation of patients' and caregivers' preferences into clinical decision making would have been useful. Recommended Readership: Primary care physicians, particularly in the United Kingdom. A better book on evidence-based medicine in primary care for a wider audience is the text by the same title edited by Silagy and Haines (BMJ Publishing Group, 1998, ISBN 0-7279-1210-0). Overall Grading:
**
Victor M. Montori, MD, Department of Internal Medicine, Mayo Clinic Rochester, Rochester, Minn
Instructions for Surgery Patients, by Steven G. Economou and Tasia S. Economou, 720 pp, with illus, $69, Philadelphia, Pa, W. B. Saunders Company (telephone: 800-545-2522), 1999, ISBN 07216-7188-8
Type ofBook: Patient information. Scope of Book: This book of patient hand-outs provides broad coverage of surgical procedures and diseases. Contents: This compendium of take-home instructions and information for surgical patients is organized into 1- or 2-page missives, generally presented in nontechnical language. The book covers several surgical specialties and is accompanied by a CDROM containing the entire book. Presumably, the surgeon prints out the appropriate section or sections and presents it to the patient as a hand-out. Simple line drawings accompany some of the discussions. Each entry is organized into general information, common signs and symptoms, diagnosis, surgical treatment, postoperative care, home care, and "call our office if' lists. Strengths: This text represents a starting point for information to share with patients. The accompanying CD-ROM provides printed pages quickly and easily. Deficiencies: The alphabetically arranged entries are somewhat confusing-some entries are diseases and others are procedures. To confuse matters further, the headings are in "patient-friendly" language rather than standard medical terminology, with no cross-referencing other than the index. This mixture of lay and medical language extends to the text as well. In addition, the copyrighted forms can be printed from the CD-ROM only as they appear in the text, despite the fact that the authors' postoperative regimens likely differ in varying degrees from other surgeons' management strategies. Topics of general interest, such as inci-
For personal use. Mass reproduce only with permission from Mayo Clinic Proceedings.