Evidence-based medicine is increasingly important, and it is a welcome directional change from the “eminence-based” training and practice common in medical imaging. The judicious use of imaging for diagnosis and management has frequently been an afterthought in the evidence-based medicine realm. With the Image Gently campaign, greater public and clinician awareness of the desirability of limiting radiation exposure, and the need for cost containment throughout the medical system, Evidence-based Imaging in Pediatrics is a timely and relevant text.
A collaborative effort between pediatric radiologists and clinical subspecialists, this book succeeds in its aim to provide a single source that gathers and ranks the pediatric imaging literature, discusses imaging pathways on the basis of the best of that literature, and provides direction for future needed research.
The text is divided into six sections. The first is a rapid review of the principles of evidence-based imaging, critical assessment of the literature, and radiation risk from medical imaging in children. The five subsequent sections are divided by regional imaging (neurologic, musculoskeletal, chest, abdominal, and fetal). These sections are subdivided by clinical diagnoses, with separate chapters devoted to imaging of common pediatric disease processes. Each of these chapters is divided in the same manner, promoting ease and speed of use. The clinical problem and epidemiology are quickly summarized. This is followed by a section on overall cost to society, including direct and indirect costs when appropriate. Goals of imaging are discussed, and the methodology of the literature search is described. This background information is followed by a more in-depth analysis of specific issues within the disease process, with supporting evidence described in greater detail. Finally, take-home tables and diagnostic algorithms are provided as a summary, and one or two imaging case studies are provided as examples.
This format allows the text to be used in multiple ways. For the busy clinician or general radiologist, the disease summaries, take-home tables, and algorithms are very helpful as quick references for what imaging is most appropriate and where it should fall in the workup. When desired, the presence of the literature analysis allows more in-depth study with this single source and provides a roadmap for further research. The evidence classification allows the busy radiologist or clinician to focus on the best of the literature.
This text is well organized, succinct, and useful as a reference for both radiologists and clinicians ordering imaging studies. It would make an excellent resource in a busy clinical practice, at hand when needed to determine the best imaging study to order. For radiologists, this text will ensure that we understand the scientific evidence behind our own imaging recommendations.
Book:
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