Eds John McDonald, Brian Feagan, Andrew Burroughs
BMJ Books, £65, pp 572 
ISBN 0 7279 1182 1
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Rating: ★★★
The purpose of evidence based medicine is to help doctors to keep up with the expanding scientific basis of medicine and to apply it to individual patients. In this regard Evidence Based Gastroenterology and Hepatology clearly addresses a need, especially for those who need to be at the cutting edge of medical sciences, such as scientists, teachers, and opinion leaders. It will be ideal if selected topics have to be discussed at a high scientific level, and will also be useful for doctors looking for confirmation of their opinions and biases—but beware, these may be scientifically proved to be wrong.
Like every good tool, evidence based medicine can be misused, and we don't mean the medical student who uses it to embarrass his or her teacher after having read up on a specific topic. Readers have to be careful not to overinterpret its role in daily medical practice. Evidence based medicine does not provide cookbook-style recipes to deal with medical problems, as the editors correctly point out in the introduction.
A study of poor scientific quality may still be clinically important. Although large multicentre randomised trials are thought to provide the highest level of scientific evidence, their inclusion criteria are usually so stringent that it is questionable how applicable their conclusions are to a typical patient seen in practice. Therefore, no one using this book should skip its first chapter, which provides thorough guidance on how to apply evidence based medicine to the care of individual patients. Evidence based medicine does not release doctors from their responsibilities, but it can help them to consider different options. In this context, this book, if used carefully, may also be very useful for practising doctors.
Those intending to use this text to update themselves on the current scientific evidence must remember that even a book dealing with evidence may contain bias, in the selection of topics and the presentation of evidence and interpretation of its scientific strength. This book certainly does not encompass the whole range of gastroenterology and hepatology, but, for those topics that it does cover, it provides an excellent reference to the current scientific knowledge.