Abstract
Regardless of one's position on the merits or drawbacks of evidence-based medicine (EBM), psychiatrists must be well versed in its language in order to participate in this important debate. Evidence-based medicine has been enthusiastically adopted by health policy makers in the belief that it will lead to reduction of healthcare costs. If we are to ensure that research evidence is applied appropriately, for the benefit of patients, then it is essential to train our profession in the skills of critical appraisal. The ever-increasing pace of publication, along with the use and abuse of the scientific literature, underscores the need for today's psychiatrist to be scientifically literate as well as clinically competent. Indeed, many would argue that the two concepts are unambiguously related.
This book is aimed squarely at candidates preparing for the Royal College of Psychiatrists Critical Review paper, a new component of the MRCPsych Part II examination. This examination paper (introduced in April 1999 to replace the Short Answer Question paper) marks an important development in psychiatric training in the UK. It also begs the question as to whether our own College will follow suit.
The impetus for this book came from the editors and board of Neurolink, an independent, multidisciplinary advisory board, sponsored by Wyeth, not the Royal College's Examinations Sub-committee. However, the editors obtained the Sub-committee's cooperation.
This publication admirably fulfils its purpose as a course manual. It contains a range of papers covering the following topics: questionnaire development; clinical audit; case register studies; case–control studies; epidemiological follow-up studies; randomised, controlled trials and systematic reviews. Unfortunately, the preparation schedule for the book precluded the incorporation of a worked-through example of a single case study. However, notes are provided on the critical appraisal of this type of study.
Each topic is dealt with using an edited version of a paper, taken from the British Journal of Psychiatry. This is accompanied by a mock examination paper, followed by model answers. The answers were provided by experienced researchers who were asked to complete the paper ‘under exam conditions’. The editors confess that some contributors ‘… admitted to taking longer’. Therefore the complexity of some answers appears to be well above that which one would expect from a candidate.
The editors note that all the papers were drawn exclusively from the British Journal of Psychiatry for reasons of copyright and expedience. The 10 papers include three examples from Australian authors and the original papers are reprinted, in their entirety, in an appendix. The editors also comment that this publication is a first effort to provide trainees with some preparation material for the examination and that it will require revision.
This book is unlikely to appeal to the clinician wishing to learn or to brush up on his or her skills in evidence-based psychiatry, or to trainees preparing for the RANZCP written examinations. This would be better achieved by using the reading list on pages 123–126. This reviewer highly recommends the publication by Greenhalgh [1]. However, Critical Reviews in Psychiatry may appeal to state-based training organisations wishing to develop a course in evidence-based psychiatry.