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McGovern, D, Summerskill W, Levi, M, et al. Evidence-based medicine in general practice. Oxford: Bios Scientific Publishers, 2001.
  1. Raquel Watkins, MD
  1. Wake Forest University Baptist Medical Center
 Winston-Salem, North Carolina, USA

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    The purpose of Evidence-based medicine in general practice is to provide a useful evidence-based medicine resource for primary care physicians. The book is divided into 5 parts: introduction, trial design, useful resources, interpretation, and application.

    The introduction consists of sections entitled natural history of disease, determining causation, outcome measures, formulating clinical questions, and hierarchy of evidence. Each section is succinct, includes a clinical example that is applicable to the general practitioner and ends with suggested readings.

    The second part of the book reviews trial designs. For each trial design, the authors explain the relevant methodology, discuss advantages and disadvantages of the design, and review questions to consider when evaluating validity. Each section ends with a good example of a study that uses the design that was described in the chapter. I found these examples helpful because they allow immediate application of the concepts that were reviewed. I also found the sections on how to interpret qualitative research and critical appraisal of questionnaires unique.

    The section on useful resources consists of lists of relevant databases including the Cochrane Collaboration, links to the World Wide Web, and an explanation of search strategies. Few clinical examples are provided in this section. This portion of the book seemed more pertinent to novices rather than experienced practitioners of evidence-based medicine.

    In the fourth section of the book the authors do an excellent job of explaining concepts such as p values, relative risk reduction, odds ratios, number needed to treat, confidence intervals, and likelihood ratios. Helpful examples are provided.

    Although this is a useful resource for general practitioners, readability would be improved by better delineation of chapters and by more generous use of diagrams and figures. A distinct strength is the case based examples. Many comparable texts are on the market, but if you are a general practitioner looking for a good resource, consider purchasing this text.


    Clinical usefulness ★★★☆☆

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    • Evidence-based medicine in general practice can be purchased online at for £24.99. The list of contents can also be viewed at this site.