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Doody's Review ServiceReviewer: Michael Benatar, MD, PhD (Emory University School of Medicine)
Description: This edited compilation aims to present a summary of the best available evidence for the treatment of a range of neurological symptoms and disorders. The authors have employed an evidence-based approach, framing clinical questions and then systematically searching the literature to find answers. Where possible, meta-analysis is used to summarize data.
Purpose: The editors' stated purpose is threefold — to summarize the most recent and important findings on treatments for neurological patients, to provide answers to at least one therapeutic uncertainty within each chapter, and to measure the benefits (and harms) of specific neurological interventions. The editors make no claim to be comprehensive and despite the title, they clearly state that they do not pretend the book to be completely evidence-based. Within these self-imposed limitations, these objectives have been met.
Audience: This book is written for general neurologists. Many of the contributors have participated in the preparation of systematic reviews for the Cochrane Collaboration. Notwithstanding the sophistication of the information presented, the writing style is almost uniformly simple and clear. The editors have produced a book that really should be accessible to students and practitioners of neurology at all levels.
Features: The first of the book's three sections is introductory, providing an overview of methodological issues in evidence-based neurology. The second section is devoted to specific neurological symptoms and the final section covers individual neurological disorders. Although the spectrum of material covered is broad, it is not exhaustive. There is also a strong emphasis on treatment, with relatively little attention paid to issues surrounding diagnosis and prognosis (but the editors' intent was not to deal with these issues). Each chapter follows a uniform style, beginning with a brief introduction, followed by the statement of specific questions that are to be addressed and then a summary of the evidence. Liberal use is made of forest plots and other schematic and tabular representation of data. A few chapters are less evidence-based than others and these are the most disappointing. Fortunately, these are few in number.
Assessment: There are relatively few other evidence-based neurological books. Among them are Clinical Trials in Neurologic Practice by Biller and Bogousslavsky (Butterworth-Heinemann, 2001), Contemporary Treatments in Neurology by Scolding (Butterworth-Heinemann, 2001), and two I have authored, Analytic Neurology (Butterworth-Heinemann, 2003) and Neuromuscular Disease: Evidence and Analysis in Clinical Neurology (Humana, 2006). The first three of these texts are similarly focused exclusively on neurological therapeutics, whereas the latter considers issues in diagnosis and prognosis as well, although exclusively within the realm of neuromuscular disease. There is little overlap between Evidence-Based Neurology and these other books and, as such, it represents an important addition to this small but growing collection.