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Book Reviews: Management of the Menopause, Clinical Evidence and Point of Care Testing

Management of the Menopause. M Rees, DW Purdie. BMS Publications, Marlow. 1999.

78pp. ISBN 0 9536228 0 0. £10 plus postage from British Menopause Society, 36 West St, Marlow, Bucks SL7 2NB.
This is a useful monograph which seeks to make available an unbiased and non-promotional book on the menopause and its management. It does what it sets out do, and will be a useful read for many professionals, and for any woman approaching or experiencing the menopause. There is much to interest, and it is full of excellent common sense. It would be hard not to find something to appreciate.

It suffers from being a bit old-fashioned in its approach, in that it fails to inform as much as Bandolier would like. Some statements are unsupported by evidence. While there may be no evidence other than good clinical judgement (and there's nothing wrong with that in the absence of good unbiased evidence), we don't know that the absence of the evidence means the evidence is absent.

Quibbles apart, this is worth having on the shelves. Non-professionals will find this of interest also, so it might be valuable for patient bookshelves as well.


Clinical Evidence. BMJ Publishing Group

ISBN 0-7279 1364 6 ISSN 1462-3846. Price £45 for one year, two issues a year in June and December. Subscriptions from

Clinical Evidence emerged from some ideas about creating an evidence formulary - a bit like the BNF with useful numbers in it. In that sense it really is an enormous undertaking, and its creators and editors are to be congratulated for even trying. It is impossible to do everything at once, so Clinical Evidence will grow and expand and get better.

It makes an excellent beginning. It tells you up front how it is put together, and contains a superb little glossary of technical terms to help you navigate through the knowledge. It tries to answer clinical questions. In this it really does seem to work very well. For instance, the section on skin diseases contains an item on head lice. Questions Bandolier was asked recently, about the evidence on nit combs or herbal or aromatherapy for head lice, were answered simply by reference to this. The questions were asked in Clinical Evidence, but no evidence was found.

The book tells you quite clearly that they try very hard to differentiate between evidence of lack of effectiveness, and lack of evidence. It does this well.

One way of telling whether a book like this is useful is to turn to a few subjects you know something about. If you do this, you will probably be pleasantly surprised. It does well. If there is any failing it is that the way results are described varies a bit between sections - some will give you odds ratios or absolute risk reductions. Others will give you NNTs. But most of us with a couple of neurones to rub together can hack this.

Bottom line to the editors is to keep up the good work. Bottom line for potential readers who are not lucky enough to get this free is to bite the bullet and buy it.

Point of Care Testing. CP Price, JM Hicks. AACC Press Washington

580pp. Available from AACC online at www. ISBN 1-890883-23-9

Point of care testing, including hospital hand-held and near patient devices, as well as home care, is big business: it will amount to over $5 billion in 2001. It is not just big business, but the generator of important sources of change in health services and their management. They also impact on patients, and in the environment where patients as customers demand more and better, the push to use point of care testing will only increase.

Ok, but what's the technology, how do you manage it, and when is it effective and when not effective? Read this book and you will find answers to most of those questions, in detail and with a philosophical and critical background. The book is up to the minute, and covers a variety of clinical settings, from the home to intensive care. It is packed with practical information from informed people, and, while it is long at just under 600 pages, the pages just seem to fly by. The only difficulty for those of us outside the USA may be obtaining it. But the American Association of Clinical Chemistry now has an Internet site so you can buy it online.
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