Article Text


Clinical evidence
  1. J E F POHL, Consultant Physician
  1. Leicester General Hospital
  2. Leicester, UK

    Statistics from

    Clinical evidence, F Godlee, series ed. pp 598. BMJ Publishing Group, London, 1999. £ 45, paperback. ISBN 0 7279 1364 6 ****

    This book is a revelation to dip into. In the age of wishing to approximate the practice of medicine to the available evidence, the first requirement is to make the relevant evidence accessible. This book, which attempts to answer clinically relevant questions, meets this requirement brilliantly, but also draws attention to the many gaps in our current knowledge. An accurate, up-to-date and critical display of information derived from randomised controlled trials and reviews based on them forms the best remedy against the uncritical persistence in old treatment habits on the one hand and succumbing to the unfortunately fashionable confusion between guidelines and protocols on the other. Clinical evidence demonstrates beyond doubt that we have at times abundant material facts to inform the former and almost never enough evidence for the latter. This is the first issue of an ongoing undertaking to provide further updated and expanded issues at twice-yearly intervals, and in order to underline the earnestness of this aim, the ‘interventions’ section at the beginning of each major entry, coloured blue for ready reference, includes one or more topics to be covered in further issues.

    Access to information is easy, aided by clear setting out, definitions of terms and concepts and explanation of abbreviations. The index is detailed enough and adequately cross referenced. Features of special value are the availability of summary tables and the appendix on estimating cardiovascular risk.

    The ultimate value of Clinical evidencedepends on fulfilling the promise of half-yearly updating but, on the evidence provided by the first issue, I can only congratulate the authors on a most auspicious start and would predict that this and future issues will become an indispensable vade-mecum for every practising doctor.

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