Textbooks
Books were once the main repositories of reports of original research, but since the advent of journals they have usually included summaries of broad topics or tables of factual information or data. Often the information in books is “established” knowledge that is not subject to rapid change (for example, gross anatomy rather than drug regimens for prevention of progression of HIV infection or AIDS). Books are vital for students and for anyone who is interested in comprehensive summaries of areas of knowledge. Two examples of broad coverage of chapters in a text are congenital disorders of the biliary tract and pancreas, and managing psychiatric emergencies in primary care. Examples of facts that can come from a book are the gross anatomy of the elbow, the incubation period of chicken pox, normal developmental milestones for 3-, 4-, and 5- month old infants, and the prevalence of osteoarthritis in Norway.
Books are often 1 to 2 years out of date when published because of the time it takes to produce, print, and distribute them.
Another criticism is that the authors seldom provide enough data from studies or cite appropriate evidence sources to support their statements. Several publishers have developed new products or presentations of established products that overcome these two criticisms. In the medical field, Scientific American Medicine20 and UpToDate21 are two excellent examples of valuable evidence-based texts. Scientific American Medicine is a large, multichaptered book with many authors available in print, CD-ROM, and Internet-based text. It is updated regularly using mailed looseleaf pages for the print version, updated disks, and the Internet. In addition, authors are encouraged to link their statements to citations that provide the evidence to back them up.
UpToDate is an electronic text that has no print equivalent. It is a CD-ROM-based product for clinicians that presents its data in a “card” or question and answer format— synopses of information organized to answer specific clinical questions and provide recommendations for therapy. Almost 1500 editors and authors identify current advances in the literature and continuously update the material using literature searches and scanning of more than 130 clinical journals. Disk updates are provided quarterly. Text material is supplemented by MEDLINE citations, case presentations, slides, radiograms, electrocardiograms, and movies, any of which can be easily extracted for use in one’s own presentations and teaching. Sildenafil (Viagra) was released on the U.S. market in mid-April, 1998 and by the summer UpToDate had comprehensive material supporting its use for sexual dysfunction in men. Many clinicians are coming to value this product. Similar “texts” will likely be developed in other fields, with further advances in provision of factual information. Clinicians need this text-based information daily, and choices should be a matter of personal preference. Care must be taken to ensure that the texts are appropriate, support routine work, and are kept current.5475
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| 5475. | McKibbon, A. PDQ Evidence-Based Principles and Practice, 1999, BC Decker Inc., Hamilton, Ontario. |