Reviewer: Valerie L. Ng, PhD MD (University of California San Francisco)
Description: This pocket-sized book is a discussion of appropriate cost-effective clinical laboratory testing and test results interpretation from a clinical perspective.
Purpose: This book fills a gap in current medical education as the authors educate users to the most cost-effective approach to using the clinical laboratory.
Audience: This book would be most useful to those early on in their medical training such as third and fourth year medical students, as well as interns and allied health professionals (physician assistants, nurse practitioners, etc.).
Features: This book is structured around common clinical syndromes and their associated laboratory tests. The authors wrote this book because of a perceived dearth of textbooks including a discussion of the use of the clinical laboratory from the clinical (as opposed to test) perspective. The authors have done a nice job of presenting rational test algorithms based on clinical syndromes. Their sources of information, however, tend to be the major medical subspecialty reference textbooks with very few primary source references. Thus, much of this book reads as a "Cliffs Notes" of Harrison's Textbook of Medicine (or other broad-based texts of hematology, hepatology, etc.). A drawback is directly related to the clinical orientation:the authors tend to emphasize test "sensitivity" and ignore test "specificity." There is a paucity of information as to what alternate clinical situations other than those under investigation might yield an abnormal lab result. The lack of discussion of likelihood ratios, and how test results affect probability of disease:again concepts linked to test specificity:is a serious deficit.
Assessment: This is a useful book for those early in their medical education who want to become acquainted with current clinical use of the clinical laboratory. The material is much too superficial, however, for those who have completed internship.