PDQ Evidence-Based Principles and Practice

Medical practice is moving steadily from a cultural tradition based essentially on priestly authority to a new tradition based on sound research evidence and full accountability to the patient and the taxpayer. The academic skills of accessing, sorting, summarizing, critically evaluating, interpreting and synthesizing information are increasingly required as core competencies in the health professions. The dozens—perhaps hundreds—of books and journals on evidence-based health care published over the past 15 years have exhorted and empowered us to move from ‘doing what seems the best’ to ‘knowing what is the best’. What, if anything, has another ‘essentials’ book on the subject to offer? I have to say I got a sinking feeling when the book (with accompanying CD ROM) landed on my doormat. the ‘PDQ’ (pretty darned quick) series, published in Canada, is marketed to students and non-experts as a set of nuts-and-bolts introductory guides to topics such as statistics, epidemiology, and now—evidence-based practice. Under that banner, the book spectacularly misses its mark. It is neither basic nor particularly accessible to the novice. But do not be put off by this error of presentation and marketing. Ann McKibbon's book is arguably the one the evidence-based medicine movement has been waiting for for ten years. It is a scholarly, indeed many would say the definitive, text on how to construct such strategies for approaching electronic databases such as Medline, Cinahl, and EMBASE. McKibbon's standing as one of the world's leading medical informaticists (along with Brian Haynes, she produced and refined the search strategies used by the international Cochrane Collaboration and offered as an ‘Advanced Search’ option on the PubMed version of Medline) is evident in her detailed exploration of the finer points of retrieving papers on therapy, prognosis, causation, and so on. The accompanying CD ROM provides these complex search strings as a searchable resource—and this alone makes the book a worthwhile investment for anyone who wishes to go beyond the basics in approaching the medical literature. The tiny font size, dense blocks of texts and illustrations that are largely limited to boxed lists of MeSH headings make this important book an extremely hard read. McKibbon has done an excellent job on the content. My advice to the publisher is to drop the ‘PDQ’ flag, season liberally with pictures and white space, and repackage this text as an authoritative reference book for the aspiring systematic reviewer.