ACP Medicine, 2004–2005 Edition
http://www.100md.com
《新英格兰医药杂志》
Does the medical profession really need yet another textbook of medicine? The editors of ACP Medicine certainly think so, considering that they have produced this 2859-page book in two volumes, a joint venture between the American College of Physicians and WebMD. (The origins of ACP Medicine can be found in WebMD Scientific American Medicine.)
How does a reviewer critically appraise an entire textbook? I used two methods to inform my review. First, in addition to skimming the entire book and carefully scrutinizing several of the chapters, I enlisted the aid of eight faculty members (from the University of Michigan and the University of California, San Francisco), who also reviewed specific chapters in detail. Second, I used this textbook in my role as a clinician. When a clinical question arose, or when I needed to learn more about a particular topic, I turned to this textbook first and kept track of how often I was satisfied with the information it provided.
ACP Medicine is organized the way most textbooks of internal medicine are, with sections devoted to various traditional disciplines such as gastroenterology and hematology. Each section includes relevant and timely topics for the practicing primary care physician, including chapters on complementary and alternative medicine, palliative medicine, bioterrorism, and genetic diagnosis and counseling. Most important diseases and disorders are included. ACP Medicine also has useful sections on gynecology and women's health, dermatology, neurology, and psychiatry, all of which the generalist physician increasingly must know. Each chapter features plentiful tables, figures, and photographs, many in color. Indeed, one of the most striking attributes of this textbook is the gorgeous pictures and figures — not surprising, given its Scientific American lineage. In addition, useful algorithms abound.
My fellow reviewers and I found most chapters to be excellent. Each is extensively referenced, and several chapters include citations as recent as 2003. Each chapter is written in the style of a qualitative review article suitable for a peer-reviewed journal (albeit much longer than most journals would allow). Perhaps with this in mind, financial conflicts of interest by authors are explicitly addressed at the end of most chapters. Especially outstanding chapters include the following (with edited comments from my reviewers noted parenthetically): "Complementary and Alternative Medicine" ("an excellent, balanced overview that provides useful information"), "Management of Common Clinical Disorders in Geriatric Patients" ("complete and well written"), "Venous Thromboembolism" ("up to date and easy to navigate, with nice flow charts that summarize the recommended workup and treatment"), "Anemia: Production Defects" ("comprehensive"), and "Contraception" ("condenses an extensive topic into relatively few pages, with each method succinctly presented").
Most chapters provide a superb overview of each covered topic and therefore would be extremely useful for readers (e.g., medical students) who are new to a discipline and who wish to gain a basic grounding in the topic. A few chapters provide useful background information but not enough depth to answer the type of specific clinical question that might be asked by a practicing clinician faced with immediate management decisions (e.g., "Should I begin this patient with Alzheimer's disease on an anticholinesterase inhibitor, and if so, what agent and dose should I prescribe?").
How useful was ACP Medicine in answering the specific clinical questions I had? After using the textbook as my data repository of first choice for the past several weeks, I found that, almost 75 percent of the time, I did not have to look further to find what I needed. Examples of clinical questions adequately answered were "How long should a patient with a deep venous thrombosis receive anticoagulation therapy?" and "How do you approach a patient with an elevated hematocrit?" The book also provided excellent background information on entities for which I needed a refresher, such as lymphomatoid granulomatosis (a brief but adequate overview) and sarcoidosis (an extensive discussion, complete with a lovely diagram depicting the pathogenesis of sarcoidosis and helpful radiographic examples of the various disease stages). On the other hand, I found ACP Medicine to be insufficient for learning about Still's disease or mycotic aneurysm — although, admittedly, these are uncommon disorders.
How else could this book be improved? I would start with minor changes such as including an index after each of the two volumes (rather than only at the end of the second volume) and reducing the large number of unnecessary abbreviations in some of the chapters (e.g., TA for Takayasu's arteritis, MPA for microscopic polyangiitis, and KD for Kawasaki's disease — all of which appeared in the chapter on systemic vasculitis syndromes). Finally, the marketplace will decide whether the price of the two-volume edition ($229) is acceptable as compared with cheaper — and better known — competitors such as Harrison's Principles of Internal Medicine (16th edition; New York: McGraw-Hill, 2004; $149 for the two volumes) and Cecil Textbook of Medicine (22nd edition; Philadelphia: W.B. Saunders; $129).
The quibbles noted above notwithstanding, the editors and contributors of ACP Medicine have done a terrific job. To answer my initial question of whether our profession needs another textbook: it does, provided that the book is excellent. ACP Medicine meets this criterion.
Sanjay Saint, M.D., M.P.H.
Ann Arbor Veterans Affairs Medical Center
Ann Arbor, MI 48104
saint@med.umich.edu((A Publication of the Ame)
How does a reviewer critically appraise an entire textbook? I used two methods to inform my review. First, in addition to skimming the entire book and carefully scrutinizing several of the chapters, I enlisted the aid of eight faculty members (from the University of Michigan and the University of California, San Francisco), who also reviewed specific chapters in detail. Second, I used this textbook in my role as a clinician. When a clinical question arose, or when I needed to learn more about a particular topic, I turned to this textbook first and kept track of how often I was satisfied with the information it provided.
ACP Medicine is organized the way most textbooks of internal medicine are, with sections devoted to various traditional disciplines such as gastroenterology and hematology. Each section includes relevant and timely topics for the practicing primary care physician, including chapters on complementary and alternative medicine, palliative medicine, bioterrorism, and genetic diagnosis and counseling. Most important diseases and disorders are included. ACP Medicine also has useful sections on gynecology and women's health, dermatology, neurology, and psychiatry, all of which the generalist physician increasingly must know. Each chapter features plentiful tables, figures, and photographs, many in color. Indeed, one of the most striking attributes of this textbook is the gorgeous pictures and figures — not surprising, given its Scientific American lineage. In addition, useful algorithms abound.
My fellow reviewers and I found most chapters to be excellent. Each is extensively referenced, and several chapters include citations as recent as 2003. Each chapter is written in the style of a qualitative review article suitable for a peer-reviewed journal (albeit much longer than most journals would allow). Perhaps with this in mind, financial conflicts of interest by authors are explicitly addressed at the end of most chapters. Especially outstanding chapters include the following (with edited comments from my reviewers noted parenthetically): "Complementary and Alternative Medicine" ("an excellent, balanced overview that provides useful information"), "Management of Common Clinical Disorders in Geriatric Patients" ("complete and well written"), "Venous Thromboembolism" ("up to date and easy to navigate, with nice flow charts that summarize the recommended workup and treatment"), "Anemia: Production Defects" ("comprehensive"), and "Contraception" ("condenses an extensive topic into relatively few pages, with each method succinctly presented").
Most chapters provide a superb overview of each covered topic and therefore would be extremely useful for readers (e.g., medical students) who are new to a discipline and who wish to gain a basic grounding in the topic. A few chapters provide useful background information but not enough depth to answer the type of specific clinical question that might be asked by a practicing clinician faced with immediate management decisions (e.g., "Should I begin this patient with Alzheimer's disease on an anticholinesterase inhibitor, and if so, what agent and dose should I prescribe?").
How useful was ACP Medicine in answering the specific clinical questions I had? After using the textbook as my data repository of first choice for the past several weeks, I found that, almost 75 percent of the time, I did not have to look further to find what I needed. Examples of clinical questions adequately answered were "How long should a patient with a deep venous thrombosis receive anticoagulation therapy?" and "How do you approach a patient with an elevated hematocrit?" The book also provided excellent background information on entities for which I needed a refresher, such as lymphomatoid granulomatosis (a brief but adequate overview) and sarcoidosis (an extensive discussion, complete with a lovely diagram depicting the pathogenesis of sarcoidosis and helpful radiographic examples of the various disease stages). On the other hand, I found ACP Medicine to be insufficient for learning about Still's disease or mycotic aneurysm — although, admittedly, these are uncommon disorders.
How else could this book be improved? I would start with minor changes such as including an index after each of the two volumes (rather than only at the end of the second volume) and reducing the large number of unnecessary abbreviations in some of the chapters (e.g., TA for Takayasu's arteritis, MPA for microscopic polyangiitis, and KD for Kawasaki's disease — all of which appeared in the chapter on systemic vasculitis syndromes). Finally, the marketplace will decide whether the price of the two-volume edition ($229) is acceptable as compared with cheaper — and better known — competitors such as Harrison's Principles of Internal Medicine (16th edition; New York: McGraw-Hill, 2004; $149 for the two volumes) and Cecil Textbook of Medicine (22nd edition; Philadelphia: W.B. Saunders; $129).
The quibbles noted above notwithstanding, the editors and contributors of ACP Medicine have done a terrific job. To answer my initial question of whether our profession needs another textbook: it does, provided that the book is excellent. ACP Medicine meets this criterion.
Sanjay Saint, M.D., M.P.H.
Ann Arbor Veterans Affairs Medical Center
Ann Arbor, MI 48104
saint@med.umich.edu((A Publication of the Ame)