Whether as a medical student or junior doctor, clinical data isubiquitous within medicine. The quantity of data that we arerequired to interpret can often make it seem as though we are in arace to the top of Everest especially when awell–intentioned consultant thrusts an ECG in front of you and asksyou to interpret it... There is nothing worse than being unable tointerpret findings in an OSCE or whilst on whirlwind ward rounds.Conversely, being able to understand and use knowledge to interpretclinical information can be thoroughly rewarding. TheHands–on Guide to Data Interpretation is the perfectcompanion and tutor for all data interpretation needs. The Hands–onGuide covers all the main laboratory, clinical and radiologicaltests used by doctors in the investigation and management ofpatients. The book is systems based and split into 16 chapterswhich include specific chapters on microbiology, genetics andimaging. Included at the start of the book is a comprehensivecollection of reference ranges including those for hormones andtumour markers. There are also conversion tables for differentunits for those of us who can t remember how to change poundsinto kilograms. The final chapter on patient data providespractical advice for clerking on the wards. This section placesemphasis on the holistic care of patients and demonstrates howknowledge can be applied by bringing specialities together. This247 page handbook is highly visual and well laid out. It is concisebut thorough. The authors have kept the student in mind throughoutand have employed a variety of techniques to help make the contentsdigestible and memorable. Such techniques include the use ofmnemonics, tables, graphs, flowcharts, diagrams and clinicalimages. Mnemonics are used broadly throughout each chapter. Theyinclude widely used favourites such as GET SMASHED for the causesof Acute Pancreatitis. Arguably they are used a bit too extensivelythroughout the book. However, they act to support learning ratherthan standing as the sole method of learning. Despite theirextensive use the layout of such mnemonics prevents them frombecoming tedious. Tables are frequently used by the authors tosummarise information or to compare and contrast key pathologies.An example which I found particular useful was the comparisonbetween Crohn s disease and Ulcerative Colitis. The table wasconcise and provided more detail than was taught in lectures. Theinformation was easy to retain and recall. I m particularlyfond of the table s ability to make me soundpseudo–intelligent on ward rounds! Graphs are used to emphasiseinformation covered in the text. They are well used throughout andinclude patterns such as flow–volume loops. Flowcharts are usesimilarly but also provide greater depth to the information in thetext and are excellent in displaying quite complex conceptual data.Particularly useful is a detailed flow chart for adrenal steroidsynthesis which all endocrinologists seem to have tattooed on theireyelids! Diagrams are clear and well presented. The majority assistinformation in tables and the text. Such diagrams are utilised wellin presenting dermatomes and myotomes in neurology which supporttextual information that describes distribution and action in moredetail. A unique selling point of this book is the helpful tipboxes which might not be found in a standard text. These handy tipboxes are found in every section and highlight salient points. Fora pocket–sized book the contents are particularly impressive. Theauthors always endeavour to explain key pathology and relate theseto findings and patterns in data. Where appropriate, importantelements of clinical examination are included, such as the cranialnerve examination. Chapters are further completed by severityscores such as the CURB–65 score for community acquired pneumoniaand by risk assessment measures such as the Well s score forthe probability of pulmonary emboli. As alluded to earlier, likemany others, I often struggle to understand ECGs. This book coversall the key principles of ECGs thoroughly and includes a simple butdetailed 10 step guide to interpretation. There are enough examplesto emphasise the points covered but perhaps not enough to becomeadept at pattern recognition. I similarly feel that examples ofx–rays are limited. However, key pathological changes are allexcellently described and accompanied by examples. It is alsoarguable that more examples might have hindered the book susefulness as a pocket guide. In both incidences this book provesexcellent as a revision tool but is not quite as useful whenapproaching these modalities for the first time. Other modalitiesare similarly explained in great detail but are lacking inexamples. A separate microbiology chapter is a real advantage ofthis book. The content is simple and understandable. Flowchartsdescribe gram staining and identification of bacteria whilst tablesare used to cover the general sensitivities of bacteria toantibiotics. I was also particularly impressed by a table offeringan introduction to oncological chemotherapeutics. The tablesuccinctly classifies agents and states the most common sideeffects for each. In conclusion The Hands–on Guide isvery useful as an introductory text to data interpretation.However, the real strength of this book is apparent when the readerhas some previous knowledge of the desired system or is using thebook for revision. I feel that the book is an unmatched text inthis respect and highly recommend it. (Owen Hibberd, 3rd yearmedical student, UEA)
"It provides an excellent reminder of background physiology withclear explanations of how this relates to tests and their clinicalapplication. For those doctors in primary care, it is also a usefultool and will be particularly helpful in interpreting thoseslightly aberrant results that fall into your inbox." (InnovAit, 2February 2012)
Format: Softbound text consisting of preface, summary oftext abbreviations, and 16 chapters, including index.
Audience: Students in medicine and health sciences, interns,residents, physicians, nurses, and other medical professionals forwhich clinical data interpretation is critical to patient care andmanagement.
Purpose: This is a pocket–sized reference containing supportinginformation appropriate to clinical application. The use ofinvestigative resources and input by experts in specific medicaldisciplines help focus the use of data to support and minimizechallenges associated with required clinical decisionefforts.
Content: The text is divided into 16 chapters addressingclinical data associated with normal ranges (clinical/physiologicalnormals), the cardiovascular system, the respiratory system,gastroenterology, endocrinology, the renal system, neurology,hematology, rheumatology, obstetrics and gynecology, ophthalmology,oncology, microbiology, genetics, imaging, and patient data. Exceptfor the first chapter on normal clinical ranges, all chaptersfollow the same presentation format. While materials arecomprehensive and well structured, references to establishedsources are only incorporated as adaptations. This textbook is aclinical guide that can be carried during clinical rotations inhospital settings. The textbook is well written, as topic coveragesupports differential diagnostic parameters leading to soundconclusions.
Usability: All chapters cover topics in a clear andarticulate manner, with consistent formatting that supportsintroductory information with specific subtopics in the chapter.Each chapter is replete with normal ranges; reference dataincluding diagrams, images, charts, tables, physiological ranges;and notes from specialists within the areas covered. As notedabove, tabular data are adaptations from sources, but there is nocomprehensive bibliographic section provided. The price of theedition is appropriate and well within reach of students,practitioners, and professionals.
Highlights: The single strength of this textbook is theamount of important and practical data packed into a small,portable textbook. Text presentations are concise and clearlywritten, supporting practicality in real–world applications. Thefinal chapter addressing patient data is a welcome enhancement tothe diverse medical specialties covered in preceding chapters,allowing for effective charting sorely needed for accuratepresentation of data in the clinical arena.
Limitations: The material presented is directly alignedwith the purpose and intent of the authors. This reviewer finds nolimitations associated with the text. However, a listing ofadditional primary references at the end of each chapter wouldserve to enhance the quality of the materials presented.
Reviewer′s Summary: After reviewing the amount ofinformation provided and comparing it to the intent of the authors,I highly recommend the text to those who require a concise andpractical reference source in medical practices. While thistextbook serves the clinical informational needs of diverse medicalaudiences, interpretation and action taken in response to clinicaldata leading to differential diagnosis should be conducted underthe guidance of an experienced medical practitioner. The authorsand contributors are to be commended on an excellent job inpreparing this textbook." (Peter D. Frade PhD, Wayne StateUniversity, in The Annals of Pharmacotherapy, April2011)
"I found it a useful reference tool in dealing with all thosehaematology and biochemistry results that we see in our dailypractice. . .Overall, an absoloute must for every GP′s bookshelf,but also a pertinent book for medical students." (GeneralPractitioner, 16 September 2011)
"This book has been written by a group of junior doctors whochose to address interpretation of the vast amounts of clinicaldata that clinicians encounter every day. I found it a usefulreference tool in dealing with all those haematology andbiochemistry results that we see in our daily practice.
It is pocket–sized, yet comprehensive. With care of morecomplicated medical conditions being transferred to the community,this sort of book will be very useful for GPs.
The book is divided into systems and the approach is logical.What I find most impressive is that the authors have beenintelligent in the topics they have included, selecting the mostcommon conditions as well as clinical scenarios doctors tend tostruggle with. At the start of each chapter is a summary of thetopics covered.
It is written in a readable and simplistic style and the formatis clear and concise. There is a plethora of tables, diagrams andcharts. I particularly liked the flowchart to differentiate betweenGram–positive and Gram–negative bacteria, the summary ofantibiotics and the tables for interpreting the minefield that LFTscan be.
Scattered throughout the book are the various mnemonics that weall learnt at medical school, such as ′GET SMASHED′ for the causesof acute pancreatitis.
This is just the sort of handbook I wish I had had at medicalschool and during my clinical training. It is a very succinctsynopsis of the common things that clinicians encounter, explainingvarious clinical examination findings, interpretation of bloodresults and other investigations, including radiology, ECGs,pleural, ascitic and lumbar puncture fluid.
The beauty of this book is that it effectively simplifies thesubject matter and gives you an at–a–glance approach to the task inhand.
Overall, an absolute must for every GP′s bookshelf, but also apertinent book for medical students. I wait with anticipation foran iPhone app." (Dr Mathukia, a GP principal in Ilford, Essex, forGPonline.com)
"What is good about this book?
The aim of this book is to provide a quick reference guide tointerpreting the wealth of data that we as doctors come across inour daily working lives. It focuses on common investigations andtests, providing summaries of how to interpret the results andapply them in the clinical setting. Divided into 16 short chapters,it encompasses the major medical and surgical specialties and iseasy to use with bullet point sections, clear headings and a fullindex that aids in rapid retrieval of information. A specialist hasreviewed each chapter, and the book includes two GP registrars anda foundation year doctor among its authors, making it highlyrelevant to the junior doctor working in either hospitals or thecommunity.
This book is set apart from other texts in its field by anextensive use of clear concise physiological explanations for bothdiseases and tests in the clinical chapters. This worksparticularly well in specialties such as neurology and haematology,where the complex is made simple. The section on the neurologicalexamination, for example, includes clear easy–to–access diagrams ofdermatomes, reflexes and visual fields, and there is a useful guidefor how to approach neurological disorders.
While the section on the interpretation of the full blood countand its abnormalities appears rather dry, it is helpful for focusedretrieval of information. Good use has been made of tables of bloodresults, with abnormal results listed alongside the normal togetherwith explanations of their relevance and suggested causes. Theliver function, hepatitis B, thyroid function and bone profiletables are excellent, combining large amounts of often complicateddata into clear summaries which are invaluable desk or bedsidetools.
The chapter on genetics, which is a frequently neglectedknowledge area, is brief but thorough and serves well as anaide–mémoire for patterns of disease inheritance. It alsoprovides useful templates for genetic diagrams, which could be usedto aid explanations during consultations with patients.
What is bad about this book?
The book can be over–complicated for such a compact reference guideand seems to lose its way at times, including an excessive amountof physiological theory or background detail. This is evident inthe discussion of lung volumes and Gram staining. Keen chemistswill recognize the Henderson Hasselbach equation in therespiratory chapter, but this too seems an unnecessary inclusion oftheory that adds little for the reader.
The cardiology section appears dense and difficult to follow andreaders may be advised to turn to a more straightforward guide forreminders on this investigation and its interpretation. Similarly,different cancers are discussed briefly in relevant specialitychapters and a separate oncology chapter tries to cover this vastand complicated subject with lengthy specific cancer stagingexamples, which readers may prefer to explore in other books.
Some diagrams have been included with little accompanyingexplanation and require further reference to the text, whichdetracts from the ability of the book to act as a quick referenceguide. The ophthalmology section also suffers from having onlyblack and white retinal images.
Finally, the book can at times read like revision notes (fromwhere the authors state that they took inspiration) and there issome unnecessary repetition; the anion gap appears in both therespiratory and the renal chapters, for example, and a descriptionof the histological findings in inflammatory bowel disease isrepeated within the same chapter.
In conclusion, this is a book largely written for the medicalstudent or hospital–based junior doctor, and overall, it is asuccinct and thorough reference guide. It provides an excellentreminder of background physiology with clear explanations of howthis relates to tests and their clinical application. For thosedoctors in primary care, it is also a useful tool and will beparticularly helpful in interpreting those slightly aberrantresults that fall into your inbox." (Dr Alexandra Davidson, GPRegistrar and Academic Fellow, University College London, forInnovAiT, June 2011)