I have been struggling lately to teach family practice residents about the principles of evidence-based medicine, the process of searching the literature, and the value of reading original research articles. That is why Gehlbach’s Interpreting the Medical Literature is timely and such a pleasure to read. Now in its fourth edition, this book continues to be a well-written and definitive guide to reading and understanding original research articles in the medical literature. It offers in-depth analyses of common study designs, a clear explanation of statistical significance, and an excellent chapter on interpreting basic statistical tests and regression—refreshingly done without a single mathematical formula!
The book itself is logically organized, beginning with chapters on various types of study designs, moving to analysis, and then interpretation. The chapters on interpretation include excellent discussions of bias, risk, and measurement. One highlight of the book is the terrific collection of examples from the medical literature that illustrate the book’s many lessons. These classic articles range from the original case-control studies of toxic shock syndrome to the Nurses’ Health Study. There is little to quibble about in this book, except perhaps to point out the wretched fact that, even with the best interpretation of available medical literature, many clinical decisions and most health policy decisions are made today without regard to the evidence at hand—the mammography controversy and prostate-specific antigen testing come to mind.
Interpreting the Medical Literature is a fine guide to the fundamental core of evidence-based medicine, the ability to read and correctly understand the medical literature. This skill is not simply about wordmanship or being able to debate the lead article in JAMA. Learning and teaching how to interpret the medical literature are critical to the success of family medicine in the 21st century. I, for one, am grateful for this book. It has helped me explain to my residents why being a good family physician means more than reading abstracts and review articles.