Evidence-based dermatology
2004; Elsevier BV; Volume: 51; Issue: 2 Linguagem: Inglês
10.1016/j.jaad.2004.03.028
ISSN1097-6787
Autores Tópico(s)Film in Education and Therapy
ResumoI do have some good excuses for why it has taken me so long to produce this review. The first is that I wanted to use each of these books in the clinic over some period of time to see how useful they were. The second is that I wanted to see which one(s) the residents and other staff would pick up most often. The third is that I have several conflicts of interest to declare. One is that I know the authors of each book. Another is that The Blue Journal is published by Mosby/Elsevier, who is the publisher of the second, and, if I can keep track of who owns who, the third one as well. Finally, I was hoping to avoid what I think I knew all along would be my conclusion before I got started: each of these books is terrific, each is useful in the clinic, and each has something to offer in style or content that complements the others. In other words, if you can, buy all three. I wouldn't say that if you've seen Citizen Kane you've seen them all, and you needn't bother seeing Gone With the Wind or Duck Soup, and I can't say that if you get only one of these books you won't be missing something. The book by Williams et al comes at the problem from a theoretical and then practical view: it teaches concepts and application of evidence-based medicine principles and then has some very good practical chapters about the management of a number of skin diseases. The concept of evidence-based medicine is detailed in 4 chapters; part 2 has 8 chapters on “The critical appraisal toolbox”; and part 3 applies these principles to 42 specific disorders. This is the book for our residents, and all of the rest of us, to learn about evidence-based medicine and how to apply it to the diseases we treat. The book by Lebwohl et al employs evidence-based medicine principles but comes at the problem directly from the angle of the practicing clinician. It is not a textbook about evidence-based medicine but a compendium on the treatment of 213 skin diseases by a collection of experts. The format of each chapter includes sections of introduction, management strategy, and specific investigation, followed by treatment recommendations divided into first-, second-, and third-line therapies, along with an assessment of how good the evidence for them is on an A to E scale. A level evidence comes from double-blind studies, B from clinical trials with more than 20 subjects, C from trials with less than 20, D from series of less than 5 subjects, and E from anecdotal case reports. This book covers more diseases than the first, and not a day goes by when we don't refer to it in the clinic, often in the presence of our patients. Shelley & Shelley follow their earlier books on Advanced Diagnosis and Advanced Treatment with another magnum opus. If, as Francis Bacon said, “Some books are to be tasted, others to be swallowed, and some few to be chewed and digested,” (in “Of Studies”), this book is to be chewed and digested, as both a main course and dessert. If experience, wisdom, and judgment count—and they do, despite what some evidence-based medicine specialists have to say about “expert opinion”—then this is the place to partake of them. Yes, a fair number of anecdotal and experiential studies are summarized and commented upon, but it is fair to say that they have been to some degree filtered and purified by the Shelley lens. This is a book for the connoisseur and the aficionado of dermatologic treatment, and for the suffering patient who might benefit from an attempt at a treatment that has not yet been sanctified by a randomized, double-blind, placebo-controlled trial.
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