Review

Three wheels on my bandwagon

QUALITY, EVIDENCE AND EFFECTIVENESS IN HEALTH PROMOTION
Davies JK and MacDonald G
Routledge, 1998, £15.00

QUALITY, EVIDENCE AND EFFECTIVENESS IN HEALTH PROMOTION.

Davies JK and MacDonald G.

Routledge, 1998. £15.00.

Evidence-based healthcare has spawned three ‘schools’ of literature: enthusiastic advocacy, dismissive iconoclasm and opportunistic bandwagon jumping. This compilation, supported by an impressive international cast and edited by two noteworthy UK academics, is quite firmly in the third category.

Although this may seem harsh, given that evaluation in health promotion has a longer pedigree than that of evidence-based healthcare, sailing beneath a flag of convenience does risk running into the storm of readers’ expectations. Unfortunately this vessel’s hastily contrived bindings fail the test.

The book’s origin is a quality and effectiveness conference held in September 1996. Randomised controlled trials (RCTs) are dismissed in a sentence and acknowledgement of the activities of the Cochrane Collaboration (incorrectly called the International Cochrane Collaboration Institute here) is confined to a single paragraph.

This is particularly surprising given the Collaboration’s recent initiatives in this specific field. Even if one accepts, as I do, the premise that RCTs alone are inadequate for evaluating health promotion, this is a flimsy pretext for such cursory treatment.

Nor can the pace of development be held responsible for this lack as the book has an impressively up-to-date bibliography. The contributors seem willing to acknowledge the terminology but not the rationale of an evidence-based paradigm.

This is not by any means a poor book. On the contrary, chapters are written with an authority and clarity that makes it a very useful entrée into the field. It is difficult to identify significant omissions in terms of either activities or issues. Nevertheless, some of the approaches, such as checklists, summary tables and evaluations of studies, come tantalisingly close to being transferable to an evidence-based analysis.

Should a future edition of this valuable work complete this shift, I will be among the first to buy it.