Current issues of ACP Journal Club are published in Annals of Internal Medicine


Resource Corner

Evidence-Based Clinical Practice

PDF

ACP J Club. 2001 Jan-Feb;134:A16. doi:10.7326/ACPJC-2001-134-1-A16



Although Geyman and colleagues state that their intended audience consists of primary-care physicians, many of the clinical situations discussed in this book are also relevant to general internal medicine consultants. This reflects well on the authors' ability to select clinical situations that are common enough to pertain to a wide variety of clinicians. This book aims to increase the reader's understanding of developments in the field of evidence-based medicine and to facilitate a greater role for evidence-based medicine in education and clinical practice.

The book covers ground that has become traditional for books about evidence-based medicine. Topics include how to find evidence and how to critically appraise the types of studies most often encountered (including diagnostic tests, therapeutics, meta-analyses, practice guidelines, decision analyses, and economic evaluations). These discussions are based on clinical scenarios and include checklists that would be familiar to those who have read the Users' Guides series published in JAMA (1). Additional topics include an excellent chapter exposing some common medical myths that show clearly that we are not already practicing evidence-based medicine, a chapter about understanding patients' choices, and chapters about the day-to-day practice of evidence-based medicine. The chapter about patient decision making is of major importance because incorporation of patient preferences is an integral part of evidence-based practice.

This book is easier to navigate than the 1st edition of Evidence-Based Medicine: How to Practice and Teach EBM (2). The 2d edition of Evidence-Based Medicine (3), however, surpasses the 1st, and I would recommend it over Evidence-Based Clinical Practice to those persons who want a book about critical appraisal or teaching EBM. I used both books recently while facilitating a 1-week evidence-based practice course with a multi disciplinary group of participants. All of the questions about evidence-based practice generated by the group were answered by both books. The main area where Geyman and colleagues' book was found to be more useful was in the chapters on how to use evidence-based medicine on a daily basis.

Richard Hardern, MB, ChB
General Infirmary
Leeds, England, UK


References

1. Oxman AD, Sackett DL, Guyatt GH. Users' guides to the medical literature. I. How to get started. JAMA. 1993;270:2093-5.

2. Sackett DL, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. Edinburgh: Churchill Livingstone; 1997.

3. Sackett DL, Straus S, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. 2d ed. Edinburgh: Churchill Livingstone; 2000.

Ratings

Methods/Quality of Information: 3 of 5 stars

Clinical Usefulness: 2 of 5 stars

Geyman JP, Deyo RA, Ramsey SD. Evidence-Based Clinical Practice. Woburn, MA: Butterworth-Heinemann; 1999.

Evidence-Based Clinical Practice can be purchased online at www.bhusa.com/medical/ for U.S. $37.50.