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Doody's Review ServiceReviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: This book by British general practitioners on the importance of incorporating evidence in the decision making process also clearly has some importance for U.S. physicians. It is, to quote from the preface, "written by practising doctors for other practising doctors."
Purpose: While physicians are familiar with dealing with uncertainty, the authors note, "it is easy to confuse personal opinion with evidence or personal ignorance with genuine scientific uncertainty. Evidence-based medicine provides a beacon which helps clarify uncertainty...." This is quite a significant statement and this book aims at making evidence-based medicine understandable to all. Although there are concepts which must be defined and explained, this book does a reasonably good job of putting it all in the context of the practicing physician versus the academician.
Audience: This is a book for all practitioners from students to attendings in the trenches attempting to explain to patients how a single study as reported in the media fits into the big picture of evidence in medicine. The authors have done a very credible job of translating the scientific language to understandable language.
Features: The most useful chapters are on trial design and interpretation. By understanding if a trial is designed well, one can then determine if the results are valid and how the trial fits into the large fund of medical knowledge. The statistics are kept to a minimum and are used to facilitate the concept rather than teach statistics. There are some further reading suggestions, but they tend to be a bit dated. The index is reasonably complete and helpful.
Assessment: This is a physician-friendly book that does not attempt to produce statisticians but to provide a working understanding of how evidence-based medicine can help overcome practitioners' biases in their daily practice of medicine. It is one of the more practical versus theoretical books available on the subject, albeit with references that are a bit outdated.