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Doody's Review ServiceReviewer: Martha L Carvour, MD, PhD (University of Iowa College of Public Health)
Description: This book provides a working statistical framework for the assessment and integration of diagnostic tests in the clinical setting. Topics include the interpretation of diagnostic and prognostic data, including information derived from routine clinical tests as well as the medical literature. All topics are presented with the clinician's perspective in mind, using clinically relevant in-text examples and multiple sample problems with each chapter.
Purpose: The authors set out to demystify the statistical principles underlying evidence-based medicine, particularly those related to diagnostic testing, in a format accessible to clinicians. Effective teaching tools and resource materials in this field are widely sought after. This book may offer a useful supplement to an evidence-based medicine curriculum but will be less useful as a reference guide for busy clinicians.
Audience: The authors apply years of experience in both the clinic and classroom to address a broad clinical audience. The book is geared toward residents, fellows, and junior faculty, although students could make use of it early in their evidence-based medicine training. The sample problems may also be useful during preparation for board exams. To many in the clinical arena, this may come across as a clinically relevant but statistically daunting book.
Features: Topics covered range from common terms in evidence-based medicine — sensitivity, specificity, and positive and negative predictive values — to those less thoroughly addressed by some resources in the field, such as measures of reliability, likelihood ratios, and propensity scores. The authors provide many illustrative, clinically relevant examples and sample problems, along with a detailed answer key. On the whole, however, the figures are a bit text-heavy (or data-heavy) for the intended audience.
Assessment: While this book is not intended to review all concepts in a complete evidence-based medicine curriculum, it may serve as a useful supplement for existing curricula or for board exam preparation. The format will appeal most strongly to readers interested in the statistical underpinnings of evidence-based diagnosis. However, sections pertaining to critical appraisal of the clinical literature and interpretation of p-values and confidence intervals may be worthwhile to readers at any stage in their clinical training.