This is based on my opinion - no data. Why not ask authors of chapters to
engage in a broad review of new published data on their topic, some sort of
grading of the strength of that data and then to give an indication to the
reader of how they went about this. Authors could be asked to cite evidence
for as many of their statements as possible and to say less if there is no
evidence or at least explicitly state "It is our practice" or "Based on our
clinical experience alone" when they feel they need to speak without quality
UpToDate, I belive, is moving in this direction well with frequent updates
of chapters (online/CD-ROM) and liberal citations with a direct link to the
Medline abstract ( a key to avoid "creative citing").
Department of Family Practice
(904) 777-7963 dsn 942
From: Rosalind Smyth [mailto:[log in to unmask]]
Sent: Monday, August 06, 2001 12:45 PM
To: [log in to unmask]
Subject: Ensuring that textbooks are evidence-based
I am an editor of a standard postgraduate medical textbook and as such am
concerned that all contributions should be evidence-based. I am aware of
different ways in which textbooks try to acheive this, but am interested in
knowing about all possible models for this.
For example, Clinical Evidence does a great job and provides a
handbook/reference guide of topics of wide general interest in healthcare.
However its question/answer presentation and limitation to interventions is
not appropriate to the more discursive format of most textbooks. These
often have to cover aspects of conditions or disease states such as
aetiology, pathophysiology, diagnosis, natural history, clinical management
etc etc, in an engaging and readable format. In many of these areas the
evidence may be thin, but statements about the current state of knowledge
need to be made.
Much of the literature in this area is likely to be buried within the pages
of textbooks and therefore not readily accessible by electornic means, which
is why I thought it would be a good topic to air to this group. My specific
1. What methods do you know for ensuring that textbooks provide a summary of
the best available current evidence in the topic areas which they cover?
2. What are the strengths and limitations of these methods?
Rosalind L Smyth
Brough Professor of Paediatric Medicine
University of Liverpool
Institute of Child Health
Alder Hey Children's Hospital
Tel: +44 (0) 151-252-5693
Fax:+44 (0) 151- 252-5456
e-mail: [log in to unmask]