Abstract
Mosby's Manual of Diagnostic and Laboratory Tests is a comprehensive manual describing diagnostic tests commonly used in clinical practice, providing a good overview of the indication, method and analysis of the tests detailed.
The numerous tests detailed are logically arranged by type of investigation, colour-categorized into blood studies, microscopic studies, endoscopic studies, X-ray studies, etc., allowing for easy referencing and searching of a given diagnostic test. Within the various categories, diagnostic tests are organized alphabetically, making searching even quicker. Herein, however, also lies an arguable shortcoming. When considering a certain type of test, for example, a complete blood cell count (CBC), the full description of each individual test comprising the CBC is spread across the first 400 pages of the book, making research into components usually undertaken together as a profile, cumbersome and difficult to follow.
Each diagnostic test follows the same layout: normal findings, indications, test explanations, contraindications, complications, procedures and result interpretations, outlining all aspects needed to understand a given diagnostic test. In addition, the authors have added symbols within the text highlighting important points such as drug interactions that may affect the results of the test, or significant items of patient information that should be highlighted prior to testing. Judicious colour boxing is used to highlight important information such as symptoms of complications.
Crucially, the information provided on each test is sufficient to enable an allied health-care professional to be able to discuss and explain it to a patient, including benefits, risks and outline of the procedure. Where relevant, the manual outlines postprocedure care in a highlighted box; this is particularly important and relevant for day cases, where the patient has to be warned about the signs of any complications that may occur after discharge.
As far as I am aware, few publications give as complete and useful a summary of diagnostic procedures in such a user-friendly format, making this book relevant to all members of the multidisciplinary team.
In its successful attempt to be multivalent and provide a complete summary of diagnostic tests to a varied audience, information on result interpretation is occasionally incomplete or insufficiently detailed to allow full interpretation. Even common tests such as chest X-rays or clotting studies are explained, but at a level that provides only marginal diagnostic guidance for a junior physician. It may have been helpful to have more details on the results expected for common pathologies as well as further diagnostic tests needed in such cases. Guidance on pathology-oriented diagnostic work-up would also have been helpful, but is possibly outside the scope of even as complete a book as this.
The most effective use of the manual would be as reference material on the wards for use by junior doctors, nurses and other health professionals. The utility of refresher knowledge on a test which the doctor or nurse is less familiar with, in order that they can explain it to a patient or understand why the team has chosen it, cannot sufficiently be over-emphasized. The few shortcomings detailed in this review do not detract from the overall value of this book. I would highly recommend it as a resource for junior doctors, but even more so, as a reference tool on the ward to benefit all clinical staff.