Ed Jean R McEwan
BMJ Publishing Group, £30, pp 245
ISBN 0 7279 1010 8
In this age of overwhelming medical information, it is more than welcome when knowledgeable people summarise and interpret the literature for us, even if the conclusions are personal and might have been slightly different. This book is a good example of how complex data can be synthesised to understandable formats for average users of the information, provided the authors know their business. These 15 authors, all British and 12 from London, have succeeded in being concise and clear, and the conclusions are, in general, useful in daily practice.
Chapter 10, by the editor, is particularly interesting. Entitled “Implementing cardiovascular strategies in hospital practice,” its appendix summarises the current local acute cardiology handbook that is used in University College London Medical School. There it is issued in a convenient size for carrying in coat pockets. We rarely read about actual hospital rules for admission and discharge, indications for thrombolysis, and the rest. The authors are to be commended for their courage to disclose their everyday strategies to a larger audience.
The other nine chapters concern subjects in cardiology that have been studied extensively in recent years (thrombolysis, heart failure, anticoagulation, risk factor management, etc). The results of clinical trials on all of these subjects force us to update our practice regularly, and this book truly helps. Conclusions drawn from the same literature may, however, be different in other countries. Depending on resources, ethical and cultural issues, and infrastructure, the recommendations may vary. Therefore, the reach of this book is largely limited to Great Britain. For example, the statements about primary angioplasty in acute myocardial infarction are remarkably conservative compared with the opinions of cardiologists from other Western countries. With the same factual observation, one may consider the glass half full or half empty, and both are right.
This type of book will probably be extinct in a few years. The changes in medicine, based on results from ever newer trials, make them outdated before the ink is dry, and McEwan’s book has not been spared in this respect. We are moving toward electronic publication of summaries of the literature, guidelines, and treatment protocols. The new media have important advantages over printed versions. The information is more widely and more easily available (also during out of office hours), and it can be continuously updated without confusions over old and new editions. Published by national societies of medical specialists, they can have the authority of a true standard and will facilitate and standardise audits of local practices.
Footnotes
Rating: ★★★