Reading Room
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Bandolier’s Making Sense of the Medical Evidence by Andrew Moore and Henry McQuay “These days everything is seemingly badged as ‘evidence-based’, irrespective of the amount or quality of evidence that is available. Too often someone will claim an evidence base when the evidence they have is a study of two men and a dog, in which the dog got better and the men weren’t ill anyway.” This handy guide is produced by the authors of Bandolier, an independent journal focusing on evidence-based healthcare. Alarmingly, we are told in the introduction that, in Bandolier’s experience, something of the order of only 1% of articles published in medical journals are scientifically sound. This guide sets out to help healthcare professionals, journalists and interested members of the public, find their way through this jungle of faulty evidence. The guide acknowledges that the peer-review system is an important step in assessing such evidence. However, it highlights that peer-review is subject to human error and by no means prevents all suspect evidence from making its way to us. It is after all just the first step in assessing research. This book aims to equip the reader with the tools to spot those trials which don’t live up to their earlier promise. Although it is very thorough, this is not a huge volume that will sit dauntingly at the top of a book shelf, too difficult to lift, let alone read. ‘Bandolier’s Little Book…’ does exactly what it says on the tin. It is divided into seven sections; a basic understanding and tools, clinical trials, observational studies, diagnostic testing, adverse events, health economics and things that don’t fit easily. Each section is divided into labelled subsections and as such it is very easy to navigate. It also has a useful glossary at the back for those readers less well-versed in medical language. Clearly written, it is as easy to read and as humorous as a book on assessing medical evidence could hope to be. It not only contains examples from previous medical trials and articles, but also examples outside of healthcare to simplify some of the ideas involved. For example, the importance of size in clinical trials is introduced with the example of two sock drawers and the issue of how many socks you would need to pull out to be (100%, 90%, 80%...) sure of the proportion of red socks in each. Finally, the book is well-presented with a large number of clear diagrams and graphs that serve to break up as well as illustrate the text. ‘Bandolier’s Little Book…’ successfully achieves its aim to enable healthcare professionals to make sense, quickly and easily, of the evidence with which they are presented and therefore be able to make informed decisions on the best options for patients. However, the clear explanation of the ideas and examples means that it is just as accessible to anyone outside of the healthcare profession who might wish to consult it. As such it will benefit patients and doctors alike and should be regarded as essential for healthcare workers and medical journalists.
Published by Oxford university Press, ISBN# 0198566042
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