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[Evidence-based medicine: how to practice & teach EBM]
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Overall rating: Excellent Strengths: Clear, conversational style; simple explanations. Weaknesses: None Audience: Practitioners at any stage, including clinical clerks This book is excellent in explaining the philosophy of evidence-based medicine (EBM) and demonstrating its application. Written for busy practitioners who want to learn and teach EBM, it is the culmination of more than 3 decades of research into the field of clinical judgement and decision-making. Much of the work was done by the authors and their colleagues in the Evidence-based Working Group at McMaster University Health Sciences Centre, Hamilton, Ont. Following an interesting introduction on the need for EBM are 5 how-to sections: asking clinical questions you can answer; searching for the best evidence; appraising the evidence; determining if you can apply valid and important evidence in the care of your patient; and evaluating your progress. Each chapter can be read in a single sitting. Concepts are simply explained, with real-life clinical examples. There are helpful tables, icons for easy searches, and the editing is flawless. The philosophy of EBM offers some apparent advantages. These include an emphasis on learning about your patient's problems, a ruthless method for managing the vast medical literature, making hidden assumptions explicit and a gut feeling that this is a clinical method of merit. Moreover, it levels the playing field between teacher and learner or generalists and subspecialists; an authoritative or hierarchical approach has little status. With its many thoughtful aids to learning the book is likely to be an indispensable resource in office and bedside practice, as well as in postgraduate training programs, particularly those in the generalist specialties. EBM could even be useful in explaining therapy or diagnosis to patients who propose alternative approaches. If I had any reservation it would be whether I would ever have the expertise and the time to...