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Smart Health Choices: How To Make Informed Health Decisions
  1. Michael Evans, MD
  1. Department of Family and Community Medicine University of Toronto Toronto, Ontario, Canada

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    Smart Health Choices aims to provide healthcare consumers with the necessary tools to assess health advice, whether from a physician, a naturopath, the media, the internet, or a friend. Unlike most resources reviewed in Evidence-Based Medicine, this book is targeted at healthcare consumers, not clinicians. It is written by an Australian trio with various perspectives: a husband and wife team (she is a “communicator” and healthcare consumer; he is a clinically trained epidemiologist) and a medical writer.

    Smart Health Choices is a small paperback with brief chapters, useful summaries, and the occasional cartoon. It has 5 sections that cover everything from identifying meaningful health claims, to finding a good doctor, to evaluating evidence. Individual chapters include discussions on such topics as “don't always rely on the expert,” choosing a practitioner, judging the evidence, and applying evidence to you and your situation.

    The book, one hopes, represents movement along the continuum from evidence only being formatted for academics or experts towards increased dissemination to frontline clinicians and, finally, to healthcare consumers. Each target group requires purposeful “packaging” of the information to make it relevant and usable.

    The authors decipher some of the core concepts of evidence-based medicine for consumers, not an easy task considering that many clinicians and learners struggle with ideal command of evidence-based medicine. I thought this book was accurate and that a consumer would certainly be more capable of participating in rational health care decision making after reading it. As with most health information, it will be used mostly by motivated, possibly well educated, consumers. I also think it would be a good read for a medical student.

    If I were to provide advice for a second edition it would be to build on what is already there. Most consumers will find the clinical examples quite powerful, and this power could be amplified. For instance, in the decision making example on hormone replacement therapy, the Heart and Estrogen/Progestin Replacement Study evidence was glossed over. I think it would be a great opportunity to show both the fluidity of evidence and the difference between experiment and observation. Another opportunity for improvement would be to provide more web based resources and resources beyond the mostly Australian examples currently given.

    I am going to pass my copy of this book on to my parents and recommend it to my patients.

    Irwig J, Irwig L, Sweet M. Smart Health Choices: How To Make Informed Health Decisions. Sydney: Allen and Unwin, 1999.

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