Dictionary of pharmacoepidemiology
by Bernard Begaud, published by Wiley & Sons, Price £45, ISBN. 0 471 80361 8
‘When I use a word’, Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean – neither more nor less’. Lewis Carroll, Through the Looking Glass.
Pharmacoepidemiology is a relatively new discipline. One of the problems with new disciplines is that their terminologies are used by different people to mean different things. It is a sign of the growing maturity of a science that its terminology becomes better defined and not subject to the whims of a Humpty Dumpty. The ultimate stage in this is the production of a standard dictionary. Begaud has assembled this dictionary which contains clear definitions for terms often thrown around with little true understanding by clinical pharmacologists, better versed in methods of drug action than in basic epidemiology. Although this is its first publication in English, it is based on a similar dictionary in French which has been through three editions. This has clearly allowed editing to remove any glitches and I could find relatively few omissions and few definitions with which I would take issue. I might quibble however, with the definitions of cost effectiveness, which is described as a synonym of efficiency – this only makes sense if you have already agreed the terms of ‘efficiency’. I think the Defined Daily Dose could have been better explained and might usefully have been cross-referenced to a source of these figures, e.g. a WHO website. The explanation for ‘ecological bias’ was correct but I thought the example (of asthma mortality in New Zealand) let it down and did not support the explanation given. I might have quibbled as well about the definition of a pragmatic trial – not that the definition given was wrong, but that I would have described it perhaps more in terms of it demonstrating effectiveness in the real world.
These are minor quibbles in a dictionary that covers several hundred terms and is very comprehensive. It is written more for the pharmacovigilance end of pharmacoepidemiology rather than the less well defined ‘outcomes research’ end of the market. I think it will fill a useful niche in the market for those involved in drug regulation and adverse event studies. A dictionary is not, of course, a textbook and access to a dictionary will not replace adequate training in the basic disciplines. It is often inadequate training in basic epidemiology that lets pharmacologists down when they try to move into this area.
My other problem with this book was its cost, which seems to me to be excessive at £45.