Medicine And Multimedia

Evidence Based Cardiology

BMJ 1998; 317 doi: http://dx.doi.org/10.1136/bmj.317.7168.1326 (Published 07 November 1998) Cite this as: BMJ 1998;317:1326
  1. John R Hampton, professor of cardiology
  1. Queen's Medical Centre, Nottingham

    Salim Yusuf, John A Cairns, A J Camm, Ernest L Fallen, Bernard J Gersch

    BMJ Books, £130, pp 1200

    ISBN 0 7279 1171 6

    Rating: Embedded ImageEmbedded Image

    Studies comparing clinical practice in different countries always show a remarkable lack of consistency in the way patients are treated. In cardiovascular disease there is a huge variation in, for example, the use of coronary angiography and percutaneous transluminal coronary angioplasty after acute myocardial infarction, and even in the use of relatively cheap treatments such as digoxin and diuretics in patients with heart failure. Why should this happen? The medical community is international, there is little debate about which are the leading journals, everyone goes to the same international meetings, and everyone has essentially the same access to the evidence on which treatment is supposedly based. One would have thought that there would be considerable consistency in the investigation and treatment of patients with …

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