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Doody's Review ServiceReviewer: Valerie L. Ng, PhD MD(Alameda County Medical Center/Highland Hospital)
Description: This is the eighth edition of a comprehensive guide for interpreting diagnostic tests. The previous edition was published in 2000.
Purpose: The purpose of this book has always been to provide a guide to how best use laboratory testing and interpret laboratory results to correctly, cost-effectively, and efficiently diagnose diseases, and provide optimal patient care. This is a worthy objective and the author has met it well.
Audience: This is best suited for consumers of clinical laboratories: physicians (students, residents, fellows, practitioners), other licensed independent practitioners, and all allied health personnel. It would also be useful to clinical laboratorians interested in how results they generate influence patient care.
Features: This book has gotten considerably larger with this edition (6 x 9 x 1.25 inches) and has significant heft; it won't fit in a pocket. Aside from the introductory chapters, the bulk of the book is divided along organ systems (analogous to the Merck Index). Each section contains a pretty comprehensive listing of diseases and appropriate laboratory testing recommendations. This edition is distinguished from previous ones by the inclusion of updated material relevant to newer technologies (molecular, HPLC, chromosomal analyses, etc.). This is truly an all encompassing compendium of medical diseases and related laboratory findings. As an example, I was quite pleased to see the inclusion of idiopathic CD4 lymphocytopenia, an entity that didn't exist until a method to reliably measure CD4 cells was developed. This is an indication of the wealth of esoterica in this edition. I noticed a few minor detracting items. The first chapter could use a fuller discussion of likelihood ratios (including the equations for calculating negative and positive LRs) and inclusion of the nomogram that quickly allows one to factor the LR and pretest probability into a post-test probability. Figure 5-3 contains a pretty significant error in that two curves are labeled as cTnI, when one should be labeled as cTnT. The d-dimer discussion in the respiratory section is excellent in distinguishing the different varieties of d-dimer testing for respiratory conditions versus clotting disorders, but it would have been valuable to repeat or cross-reference it in the clotting section. The relative lack of d-dimer discussion in the clotting section is unusual.
Assessment: This is a pretty useful book. I would recommend it to physicians and allied health practitioners.