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The Pocket Guide to Critical Appraisal by Ian K Crombie. BMJ Publishing Group, BMA House, Tavistock Square, London WClH 9JR, 1996 (ISBN 0 7279 1099X). 66 pages. €8.95.

This small book is aimed at all health care professionals with a view to introducing them to, and encouraging critical appraisal of medical literature. It is concise and the author intends readers to take it with them on visits to the library.

The book consists of 11 chapters which may be divided into two sections, the first five chapters providing an introduction and overview of the appraisal process, and the final six covering specific questions to ask when appraising reports using specific research methods.

The early chapters cover aspects of identifying the research method, the questions asked and answered by the study, and the analysis of the results. These sections are certainly not exhaustive in their detail, but they are reminders of what to bear in mind while reading the litera- ture.

The later chapters cover standard appraisal questions, and then specific types of study, ie surveys, cohort studies, clinical trials, case- control studies and review papers. Each chapter here identifies the essential questions for the study type, and then specific questions to consider, finishing with a check list comprising all the questions. Brief examples are used to illustrate the questions posed, and how they might be answered.

Generally I found this book very readable. The language is on the whole very user friendly, and not packed with jargon, although where technical terms are used they are explained. The style of writing does vary, however, and this inconsis- tency may irritate some.

The concise form of the book is both its strength and its weakness. The author refers in the preface to the need t o keep the text brief, which in itself makes it easy to read and use. Inclusion of other types of study, however, such as qualitative, clinical audit and health-econ- omic studies would increase its usefulness; perhaps they will arrive in a sister text.

Notwithstanding this shortfall, this text should find a wide reader-

ship. It would certainly find a place in complementing other texts currently used to teach the under- pinning knowledge of research methodology, both a t undergrad- uate level and beyond. It should also be of use for those in the profession who have not had a formal research training and may wish to develop a more questioning approach t o reading and reviewing medical liter- ature.

In these days of evidence-based practice, anything which informs on the nature and worth of the evidence presented should be of value to us all.

Grahame Pope MCSP

Managing Outcomes through Collaborative Care The application of care mapping and case management

Published by The Center for Case Management, edited by Karen Zander. American Hospital Publishing Inc, 737 North Michigan Avenue, Suite 700, Chicago, Illinois 6061 1-2615, USA, 1995 (ISBN 1 55648 132 2). Illus. 207 pages. $70.74 including shipping and handling, must be prepaid in US funds.

This softback book looks in depth at the management issues of setting up, running and evaluating critical pathways, care and case manag- ement systems for patient care. Each of ten chapters is written by one of eight authors, all of whom are practising nurses or medical doctors, most also having a manage- ment or academic background.

Written primarily for an Amer- ican market it assumes a working knowledge of US health care systems and is sprinkled with abbreviations and acronyms that can leave the average British reader puzzled. Despite this, the book is well laid out, looking a t the ratio- nale for different models of patient care management systems, their pros and cons, choices of models suitable for different health provider units, their implement- ation and evaluation. Clear figures show both theoretical models and worked practical examples.

Although physical therapy is mentioned only in passing as part of the multi-disciplinary team, it would be relatively easy for phys- iotherapy managers to adapt the principles of the organisation and

processes of the management systems discussed for UK use. Useful hints are given for design- ing care plans with a view t o computerisation.

The American model claims throughout to be patient-focused, and although patient outcomes are key elements in the pathways and plans, they are mostly pre-imposed and there is little evidence t o suggest that current or potential patients and carers have been involved in the processes, either in setting up these care pathways or in deciding specifically patient-focused outcomes.

This text is a useful handbook for anyone thinking about setting up critical pathways or managed care models as the processes are clearly identified and the principles involved are largely adaptable t o the UK health care system.

Sue Barnard MCSP

Getting the Most from Your Primary Care Team published by the Carers National Associ- ation, 20/25 Glasshouse Yard, London EClA 4JS, 1997. Illus. 8pages. f3.50per 25 booklets.

Intended for distribution t o patients, this leaflet explains who makes up a primary health care team and how to obtain support for both patients and carers. Its value will be shown when it is in general circulation; some of its advice would seem like a statement of the obvious to a health care professional.

Interspersed with cartoons (see below) and sturdily produced, it is in good time for National Carers Week - June 9-15, 1997.

~ ~~ - Physiotherapy, May 1997, vol83, no 5