Review

Evidently effective

EVIDENCE-BASED AND COST-EFFECTIVE MEDICINE FOR THE UNINITIATED
Tony Lockett
Radcliffe Medical Press, 1997

This book provides a guide to the two ‘buzz-phrases’ evidence-based medicine and cost-effective medicine and, as the title suggests, assumes no prior knowledge. Although a great deal has been published on both subjects in recent years, this book will be a useful addition to an ever-growing bookshelf. Short, concise and readable, the book provides an honest introduction to two important concepts in health care today.

Beginning with a look at decision-making in medical practice, the book looks critically at evidence-based medicine and cost-effective medicine separately, considering the practicalities involved in their application. Evidence based medicine is discussed in relation to its history, effects, ethics and problems. The author looks closely at the processes involved in evidence-based medicine although, as an information scientist, I would have liked to see more space devoted to finding the evidence!

The following section deals with cost-effective medicine. The author has chosen to examine the process of cost-effectiveness analysis and the effects and possible disadvantages of this style of decision making. Markov models, or decision trees, are used to demonstrate cost-effectiveness based decision making in action, which is a helpful way of describing a complex process.

Both concepts are brought together in the final chapter where the author considers the choices involved in using either approach and the relationship between evidence-based medicine and cost-effective medicine.

Although covering two widely-written subjects, the strength of this book is in its readability. For busy professionals, this book is ideal with its short chapters and plain english style. Each chapter starts with a very handy summary of key points from previous chapters and sections and a list of references or suggestions for further reading, which are up to date if a little short.

The author has succeeded in writing a book which provides a structured and readable overview of two predominant styles of decision making and the associated issues whilst managing to avoid unnecessary jargon.

The book should prove useful to students of health care and indeed, health professionals looking for a basic introduction to these two topical subjects.