Ed Leone Ridsdale
Harcourt Brace, £17.50, pp 176 
ISBN 0 443 05889 X
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Rating: ★★★
Using external evidence to inform clinical decision making is now acknowledged as an important and necessary ingredient of good clinical practice. However, using external evidence depends on formulating an answerable question, finding and appraising evidence, and applying the evidence to the individual patient. Leone Ridsdale is to be congratulated on editing a relevant and accessible book that shows how evidence based medicine can be applied to clinical problems in primary care.
The structure of the book is based around well rehearsed aspects of diagnosis, prognosis, and treatment. There are also chapters on searching, qualitative research, guidelines, audit, and teaching and learning evidence based practice. All the authors use examples of common problems in primary care and adopt a pragmatic, realistic approach. My main quibble is the omission of information about how to frame a clinical question (although this is covered in some of the chapters in the book). In my experience of teaching medical students and postgraduates, the major difficulties with understanding and using evidence based medicine centre around formulating answerable questions to common clinical problems.
Many people will find this book useful: registrars approaching the MRCGP exam will find it relevant to the critical reading part of this exam; medical students, who are increasingly being taught how to integrate external epidemiological evidence into clinical problems; and teachers concerned with undergraduate or postgraduate curriculums. Most of all, it should appeal as an accessible text to those members of the primary healthcare team who wish to inform themselves about what evidence based medicine is and what relevance it has to their own clinical practice.
While it is filling a gap in the market about evidence based medicine, it is only one of several recently published books concerned with evidence based practice in primary care. All have adopted a similar problem based approach. So, although I enjoyed this book, it occupies a niche with a growing collection of similar texts. Which to choose? If you are thinking of refurbishing your practice library make sure you have the original text: Clinical Epidemiology by Sackett, Haynes, Guyatt, and Tugwell. If you wish to choose a second text with a focus on primary care, this book will not let you down.