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 Book Review Pharmacovigilance from A to Z:
Cobert and Biron's Pharmacovigilance is a welcome addition to the dictionaries that help us to cope with an ever-expanding world of ‘Babylonian priest languages': our ways of communicating within our specialties, often strange and impenetrable to the outside world. The authors offer us a reader-friendly dictionary, particularly interesting to anyone involved in clinical pharmacology and drug research. Dictionaries, like any specialty book, may be written either by an extended number of contributors, as are Last's Dictionary of Epidemiology, Armitage and Colton's Dictionary of Biostatistics or Gail and Benichou's Encyclopedia of Epidemiologic Methods, or by one or two writers, like this volume or Paul Vogt's Dictionary of Statistics and Methodology: A Nontechnical Guide for the Social Sciences. The former approach produces high-quality information, which is sometimes more detached from some unifying concept. The latter allows the authors to put more of their souls into their writing and produce, in a more harmonized state of mind, a better line of thought throughout the whole message. As always, the product depends more heavily on the experience of its authors. Pharmacovigilance appears to me to be a very informative text. Its major asset is its originality in covering the growing field of drug surveillance, which is known to the authors from within and in many subtle details. However, any reader of book reviews is interested not only in kudos but also in drawbacks and in at least some major aspects where there is space for improvement. This dictionary covers pharmacovigilance as a part of the domain of pharmacoepidemiology, which itself is a part of fundamental and clinical epidemiology. The authors should stress the definitions or concepts that are more specific to this sub-domain and that are different from those used in the outside world of clinical epidemiology and biostatistics in particular. Some entries are not specific enough. For example, epidemiologic studies (p. 74) are seen solely as observational. While discussing phases of clinical trials and assessment of drugs, the authors might be more clear about what is covered by pharmacovigilance itself. Pharmacovigilance also covers what may be called “phase V” assessment of drugs. In phase V, as in Phase IV, there are no pre-selected patients, but instead of desired treatment effect, phase V focuses on any rare consequences resulting from the administration of a drug. Elsewhere, I was puzzled by what “statistical causality” means. Levels of causality, as proposed by the authors, are solely conceptual and not operational. For example, what distinguishes a “probable” causal relationship from a “possible” one in clear and usable terms? Categories of causality are defined in the book by their field of use, such as medicine or law, rather than by their substance. Do the authors perceive different concepts as identical to different domains of use? The same applies to other entries, where it is not clear whether the definition and field of use are within some more general concept or if they are different. Some other entries describe situations of their use rather than definitions of terms themselves. For example, “case reports” or “case series” are not defined at all! If some terms are not defined well enough, the authors should guide the reader to their definitions elsewhere, for example, the abovementioned Dictionary of Epidemiology, endorsed by the International Epidemiological Association. Hence, the reader should not expect that Pharmacovigilance will provide an essential dictionary of epidemiological and other terms without pairing this reading with other ad hoc references. Some more than ubiquitous terms, such as “epidemiology” or “evidence-based medicine” are not mentioned and defined. The “Introduction” section of this book might be improved by the addition of a reference to other dictionaries and basic reading, which might help the reader to expand and complete his or her understanding of pharmacovigilance terms as they are gathered in this volume. I would like to find definitions of “efficacy”, “effectiveness” or “efficiency of treatment”, as well as a cost/benefit assessment including non-monetary considerations. Adverse effects represent one of the costs of treatment. What about evidence-based principles to be kept in mind in pharmacovigilance and how might we define “evidence-based pharmacovigilance” itself? A word about “evidence-based pharmacology” would also merit a place in this book. Even if we dislike or disagree with some term or domain, it is not a sufficient reason to exclude it from a dictionary. All this reviewer's ramble should not blur the relevance and the originality of Pharmacovigilance. This dictionary will stand as a useful and very original tool for years to come. It will also help health professionals who are farther away from clinical pharmacology to better understand the domain it covers. Overall Rating: Strengths: Weaknesses: Audience: Milos Jenicek, MD Professor, Clinical Epidemiology and Biostatistics
Book Review A Veritable Scoff: Sources on Foodways and Nutrition in Newfoundland and Labrador
“A Veritable Scoff presents summaries of 170 writings on Newfoundland and Labrador foodways and nutrition for the past several centuries. Is the popularity of boiled dinner – salt beef or pork with root crops – on the wane? Why do the Innu of Davis Inlet call Social Services “the food boss”? How prevalent was beriberi in pre-Confederation Newfoundland? What are dietitians and food scientists in the province concerned about now? The only book of its kind in Canada, this bibliography answers these questions and asks others that are equally compelling.” [Text from the book jacket.] Overall Rating: It provides a fascinating historical review capturing the highlights of foodways and nutrition from 1600–2000. It is applicable to today's decisions regarding health and nutrition policy and provides a transferable guide to other jurisdictions where such a review is being considered. Strengths: Weaknesses: Audience: Eleanor Swanson Director, Planning and Evaluation [Previous] [Table of Contents] [Next] |
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Last Updated: 2003-01-06 |  |
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