Reviewer: Sean D. Ruland, DO (University of Illinois at Chicago College of Medicine)
Description: This book deals with the outcomes of a select and rather limited number of neurological and neurosurgical pathological entities. I recently had the opportunity to review, quite favorably, a text of a similar nature, which will serve as a good comparison to this one.
Purpose: The objective of this work, inferred from the preface, is an outcome comparison of different treatment strategies in order to derive a standard of care.
Audience: It is intended for the practitioner, the third party payer, and those in the legal system. In my opinion, any attempt to produce a single review of scholarly medical literature written to target and be practically applicable to all three audiences is a feat of impossibility, this book not withstanding. As a physician requires the assistance of an attorney, accountant, business manager, etc., to make sense of the others' professional jargon and successfully fit his or her services within the boundaries of society set forth by rules of business and the medical judiciary, so too would a businessman or a lawyer need an extensive education in the neurological sciences to make useful sense of a text such as this. (There are those rare occasions of dually degreed individuals who breach this gap.) Therefore, in my opinion, this book is written for an audience of practitioners/trainees in the neurosciences.
Features: As the preface notes, each contributor has approached his/her topic in a slightly different manner. For the most part, a brief introduction to the pathophysiology of an entity is provided, followed by a plethora of statistical outcomes from various small scale to large scale studies that have been published in various places in the literature. In some cases, the studies apply to treated versus untreated or one treatment versus another treatment, but these data are not consistently available and therefore no conclusion can be drawn about what the "standard" should be. Some authors attempt to provide pearls as to what clinical/ancillary features predict better or worse prognoses, but for the most part, I found this information lacking. There are many charts with statistics but few photos or illustrations.
Assessment: Another recently reviewed text, entitled Prognosis in Neurology by J. Gilchrist (Butterworth-Heinemann, 1998) deals with the ability to clinically predict, based on clinical markers, outcomes and treatment differences with the objective of allowing physicians and patients to make informed treatment and/or life decisions. This is in keeping with the contention many of us still maintain, that medicine is an art of practice. This book contrasts with that approach by suggesting that standards can be drawn for providers and the judiciary based on the limited amount of knowledge that exists. The reality is that there are many more questions on a given topic than there is hard-core evidence to answer them. Even with the rapidity and quantity of recent advances, neurologic practice remains strongly anecdotal and empirical. This book contains a fair amount of information. Lacking, however, is any novel information or ideas with which to enrich one's practice or add to the strength of one's reference library.
'With the plethora of authoritative neurology textbooks, do we need another? This new publication, I believe, makes a strong case that we do … Professor Swash must be congratulated on this massive endeavour … The publishers have also done a wonderful job, with excellently laid out tables and clear diagrams.' Journal of The Royal Society of Medicine
'… an ideal introduction to those wishing to appreciate the clinical as well as financial implications of the therapies which are in today's repertoire. In attempting to bring outcome measures, outcomes, and financial aspects to our minds, this book certainly does achieve its goal.' Cephalalgia
'The authors are obvious experts in their fields and impart knowledged in a concise and easily understood manner … The book is exhaustively referenced and when read selectively is a very valuable source of information.' Neuroradiology
2 Stars from Doody
This book deals with the outcomes of a select and rather limited number of neurological and neurosurgical pathological entities. I recently had the opportunity to review, quite favorably, a text of a similar nature, which will serve as a good comparison to this one. The objective of this work, inferred from the preface, is an outcome comparison of different treatment strategies in order to derive a standard of care. It is intended for the practitioner, the third party payer, and those in the legal system. In my opinion, any attempt to produce a single review of scholarly medical literature written to target and be practically applicable to all three audiences is a feat of impossibility, this book not withstanding. As a physician requires the assistance of an attorney, accountant, business manager, etc., to make sense of the others' professional jargon and successfully fit his or her services within the boundaries of society set forth by rules of business and the medical judiciary, so too would a businessman or a lawyer need an extensive education in the neurological sciences to make useful sense of a text such as this. (There are those rare occasions of dually degreed individuals who breach this gap.) Therefore, in my opinion, this book is written for an audience of practitioners/trainees in the neurosciences. As the preface notes, each contributor has approached his/her topic in a slightly different manner. For the most part, a brief introduction to the pathophysiology of an entity is provided, followed by a plethora of statistical outcomes from various small scale to large scale studies that have been published in various places in the literature. In some cases, the studiesapply to treated versus untreated or one treatment versus another treatment, but these data are not consistently available and therefore no conclusion can be drawn about what the ""standard"" should be. Some authors attempt to provide pearls as to what clinical/ancillary features predict better or worse prognoses, but for the most part, I found this information lacking. There are many charts with statistics but few photos or illustrations. Another recently reviewed text, entitled Prognosis in Neurology by J. Gilchrist (Butterworth-Heinemann, 1998) deals with the ability to clinically predict, based on clinical markers, outcomes and treatment differences with the objective of allowing physicians and patients to make informed treatment and/or life decisions. This is in keeping with the contention many of us still maintain, that medicine is an art of practice. This book contrasts with that approach by suggesting that standards can be drawn for providers and the judiciary based on the limited amount of knowledge that exists. The reality is that there are many more questions on a given topic than there is hard-core evidence to answer them. Even with the rapidity and quantity of recent advances, neurologic practice remains strongly anecdotal and empirical. This book contains a fair amount of information. Lacking, however, is any novel information or ideas with which to enrich one's practice or add to the strength of one's reference library.
