EBM in your pocket | |
Evidence-based medicine. How to practice and teach EBM. David L Sackett, W Scott Richardson, William Rosenbery, R Brian Haynes. New York: Churchill Livingstone 1997 (xii + 250 pp.). ISBN: 0 443 05686 2. |
Evidence-based medicine (EBM) is widely accepted as the way we should practise medicine and David Sackett is recognised world-wide as a leader in this important movement. This pocket-sized booklet shows why so few of us use the principles of EBM in our everyday practice -- it's a different way of looking at what we should do, and it's hard work. The authors of this book urge us to critically examine the methods and results of clinical research and to ask and answer some difficult questions. Primarily, we should be asking: are the research results valid, are they important and can I apply them in my clinical practice? David Sackett and the editorial team do a remarkably good job of outlining and summarising the principles of EBM and provide useful summaries on separate plastic cards which are easy to access and which quickly become familiar with use. The pocket size and the plastic summary cards are a practical attempt to integrate the principles of evidence-based medicine into the actual clinical setting. For example, there are plastic cards containing a summary of the best MEDLINE search terms for a variety of clinical areas, which could facilitate a literature search during or at the end of a clinical encounter. These cards have proven extremely popular, and would-be purchasers should check for them inside the back cover. The chapters are well set out and can be read separately. This is just as well as the book is not a quick read. We felt it necessary to read and re-read chapters carefully. The "instruction manual" approach seems quite effective and numerous examples show how the principles can work in practice. The sections on how to teach EBM are useful to the potential teacher, and the book certainly complements ongoing moves towards a more problem-based, self-directed learning approach for undergraduates and postgraduates. Overall, we found reading and assimilating the principles hard work but were glad we made the commitment. Patrick J Phillips Brian J Smith
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