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Doody's Review ServiceReviewer: John K. Larson, MD (Rush University Medical Center)
Description: This is an extremely well-organized, concise introduction to evidence-based medicine by faculty, residents, and fellows at the University of California, San Francisco. It is a softcover, deceptively thin textbook, too large to slip into a lab coat pocket.
Purpose: It presents the essential components of evidence-based medicine with ample illustrations of practical application of each component to real clinical practice.
Audience: The targeted audience includes healthcare providers at all levels of experience including medical and nursing students, residents, and veteran practitioners. While the clinical examples are drawn largely from internal medicine, the material is applicable to any specialty. It will also find its way into the hands of well-informed policy makers and anyone else who critically evaluates medical literature.
Features: It is divided into three sections. The first section is concerned with medical decision-making techniques and includes discussions of topics such as refining probability, the five steps of decision analysis, treatment and testing thresholds, and cost-effectiveness analysis. The second section addresses the process of accessing medical information with a particularly practical introduction to MEDLINE. The third section contains three chapters on the critical assessment of the validity of medical information. There is a very brief appendix consisting of life-expectancy tables and a thorough index. Inside the back cover is a plastic bookmark with an outline of the information available in Section Three. There are numerous illustrations, flowcharts, and tables to clarify important points. All chapters are consistent in tone, quality, and format with the frequent use of clear content outlines and bold type to emphasize major points.
Assessment: This is an extremely successful attempt to introduce the essential elements of evidence-based medicine to the healthcare professional. In spite of potentially dry subject matter, it is eminently readable and applicable to actual clinical practice. It should also serve to persuade even the most jaded skeptic that evidence-based medicine is not a passing fad, but rather the next step in the logical evolution of scientific medical practice.