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Doody's Review ServiceReviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: Beginning with a discussion of what the phrase "evidence-based" means, this book on diagnosis helps clinicians understand how the statistics tell us whether a test is valuable. As an update of the 2007 edition, this book looks at the studies published since then, adding significantly to the understanding of the evidence.
Purpose: The purpose is to catalogue the overwhelming amount of studies on bedside examination and accuracy in detecting disease, solving clinical problems, and predicting outcomes. This is tremendously important as there are many published studies that simply do not stand the test of the scientific method and result in confusing results for clinicians. This book greatly helps in separating the studies that are based on good evidence from those that are less rigorous and less dependable.
Audience: This book is valuable for all clinicians, helping them to understand what diagnostic criteria they can depend on in a cost-effective practice and which are less valuable.
Features: The beginning chapters develop the definitions and the basic statistics, charts, and graphs that are used in the book. The author has done a masterful job of transforming the dry information of statistics into an intuitive process. Subsequent chapters look at the literature and the traditional way medicine has been taught, such as in cardiac auscultation, and helps shine the light of current evidence on them, showing what a clinician may depend on and what is less dependable. I was particularly impressed by the musculoskeletal section, which examined some of the physical diagnostic signs of function.
Assessment: This is an exceptionally well-written book on the literature to determine if a diagnostic or therapeutic test has accuracy. It is well worth the price. I recommend this book to every clinician in the practice of medicine.