2
252 years, represents probably the most complete atlas of angiocardiography of cardiac malforma- tions available. In addition to the lavish and high-quality illustrations of angiocardiograms, the book also includes many illustrations of the pathology of different defects. Diagrams are also used widely to augment the text. Dr. Freedom and his colleagues have concentrated in this volume on correlating the angiocardiographic findings and morphological features in each malformation. The descrip- tions of abnormal cardiac anatomy are comprehensive and the referencing throughout the book is exhaustive. The result is a book which provides not only a comprehensive review of angiocardiography, but also a useful reference on the morphology of congenital cardiac defects. In the chapters relating to simpler abnormalities such as atria1 septal defect and persistent arterial duct, the relatively minor role of angiocardiography is freely acknowledged. In other situations the complementary role of other imaging techniques such as cross-sectional echocardiography are placed in appropriate perspective - as in the demonstration of atria1 arrangement (“situs”). The book includes sections relating to some rare and complex malformations which are sometimes treated superficially, even in the larger reference texts. Such abnormalities as supero-inferior ventricles, criss-cross hearts. double outlet left ventricle and the rare problem of thorocopagus conjoined twins are all dealt with in some detail. The text has few defects, though the nomenclature adopted for “univentricular hearts” appears to be a rather weak compromise between the two main systems in current use. One minor aberration is apparent in the description of illustrations relating to double chamber right ventricle. The text and the legends refer to muscle bundles separating the inlet portion of the right ventricle from the apical trabecular zone, but the angiocardiograms shown demonstrate muscle bundles in a more distal position, separating the apical trabecular zone from the infundibulum (Fig. 17.1). All in all this is a superb compendium of angiocardiograms which is clearly presented with accurate correlations relating to the pathological anatomy in the different defects. It will be an extremely valuable addition to every paediatric cardiac library. It is to be strongly recommended to all paediatric cardiologists and cardiologists or radiologists who investigate patients with congenital heart disease. It will also be of great value to cardiac surgeons and morphologists and to all who are involved with the investigation or treatment of children with cardiac malformations. Royal Liverpool Children’s Hospital Liverpool, U.K. James L. Wilkinson * Using and Understanding Medical Statistics D.E. Matthews, V. Farewell S. Karger, Base]-New York, 1985; 212 pp.; SFr48, DM57, $28.75; ISBN 3-8055- 3932-0 This book uses a very different approach from the usual “ medical statistics” textbooks, and attempts to give (and I think succeeds well) a sound and deep understanding of statistical methods using relatively simple mathematics. If you are looking for a simple “cookbook” with recipes and worked examples, however, this is NOT the book for you. Similarily, if you want a simple book to learn quickly about elementary significance tests, then this is NOT the * Member of the Editorial Board of the International Journal o/ Cardioloo.

Using and understanding medical statistics

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252

years, represents probably the most complete atlas of angiocardiography of cardiac malforma- tions available. In addition to the lavish and high-quality illustrations of angiocardiograms,

the book also includes many illustrations of the pathology of different defects. Diagrams are also used widely to augment the text.

Dr. Freedom and his colleagues have concentrated in this volume on correlating the angiocardiographic findings and morphological features in each malformation. The descrip-

tions of abnormal cardiac anatomy are comprehensive and the referencing throughout the book is exhaustive. The result is a book which provides not only a comprehensive review of

angiocardiography, but also a useful reference on the morphology of congenital cardiac defects.

In the chapters relating to simpler abnormalities such as atria1 septal defect and persistent arterial duct, the relatively minor role of angiocardiography is freely acknowledged. In other situations the complementary role of other imaging techniques such as cross-sectional echocardiography are placed in appropriate perspective - as in the demonstration of atria1 arrangement (“situs”). The book includes sections relating to some rare and complex

malformations which are sometimes treated superficially, even in the larger reference texts. Such abnormalities as supero-inferior ventricles, criss-cross hearts. double outlet left ventricle and the rare problem of thorocopagus conjoined twins are all dealt with in some detail.

The text has few defects, though the nomenclature adopted for “univentricular hearts” appears to be a rather weak compromise between the two main systems in current use. One minor aberration is apparent in the description of illustrations relating to double chamber

right ventricle. The text and the legends refer to muscle bundles separating the inlet portion of the right ventricle from the apical trabecular zone, but the angiocardiograms shown

demonstrate muscle bundles in a more distal position, separating the apical trabecular zone from the infundibulum (Fig. 17.1).

All in all this is a superb compendium of angiocardiograms which is clearly presented with accurate correlations relating to the pathological anatomy in the different defects. It will be an extremely valuable addition to every paediatric cardiac library. It is to be strongly recommended to all paediatric cardiologists and cardiologists or radiologists who investigate patients with congenital heart disease. It will also be of great value to cardiac surgeons and morphologists and to all who are involved with the investigation or treatment of children with

cardiac malformations.

Royal Liverpool Children’s Hospital Liverpool, U.K. James L. Wilkinson *

Using and Understanding Medical Statistics D.E. Matthews, V. Farewell

S. Karger, Base]-New York, 1985; 212 pp.; SFr48, DM57, $28.75; ISBN 3-8055- 3932-0

This book uses a very different approach from the usual “ medical statistics” textbooks, and attempts to give (and I think succeeds well) a sound and deep understanding of statistical methods using relatively simple mathematics. If you are looking for a simple “cookbook” with recipes and worked examples, however, this is NOT the book for you. Similarily, if you want a simple book to learn quickly about elementary significance tests, then this is NOT the

* Member of the Editorial Board of the International Journal o/ Cardioloo.

253

book for you. The authors say the book is written for “the motivated reader who is willing to invest a little time and effort in understanding statistical methods”. This indicates well their

philosophy. The reader who is willing to start at the beginning and carefully read the 200 pages will gain a good understanding of medical statistics. Nonetheless, the medical reader who opens this book at random is certain to be discouraged by seeing the seemingly complicated mathematical symbols and equations which have been gradually introduced over previous chapters.

In content, too, this book departs in a welcome way from the standard texts. Although tests such as the t-test are obviously covered, more emphasis is given to very detailed descriptions of methods such as survival curve analysis. Less familiar techniques such as

logistic regression (an extremely useful tool which, because it is relatively new, is less widely

used than it deserves to be) are well described. As with any book, one is tempted to complain of faults and omissions. Thus, for example.

“the regression line of Y on X is not the same as that for X on Y” is a concept which is

frequently misunderstood by non-statisticians. 1 was surprised to find it dismissed in a mere

couple of lines. Overall, however, I felt that the coverage of techniques was well balanced and suitable for the intended audience. The printed text is clear and well laid out, as are the figures and tables.

This book is suitable for use with courses on medical statistics, and indeed arose from such

a course. As I have implied above, it may not be the simplest of introductory texts.

Nevertheless, I would strongly recommend other readers to make the necessary effort!

Medical Research Council Brompton Hospital

London, U.K. Peter M. Fayers

Clinical Heart Disease Samuel Oram Heinemann Medical Publishers, London, 1981; 853 pp.; E50; ISBN o-433-24201-9;

paperback edition 1984; f27.50; ISBN o-433-24202-7

This well-known cardiology textbook has been extensively updated. Out of all the develop- ments that have taken place in cardiology since the first edition I could not find a significant omission. There are sections on Doppler cardiography, prostaglandins and their effects on the

cardiovascular system, and even on the often ignored apexcardiogram. yet the important chapters on clinical examination and those interesting little historical notes are retained in

full. The obvious drawback to the inclusion of so many subjects is that none can be explored

very thoroughly. Although there are excellent chapters on Cardiomyopathies and Diseases of Vessels, the book does suffer in this respect. For example the section on cross-sectional echocardiography, which in the preface is heralded by the author as the most important investigative development, is confined to five pages and is poorly illustrated.

Throughout the book there are very many useful and illuminating diagrams and illustra- tions although, for a book of this price, the quality of the photographic reproduction is rather poor. Unfortunately all the illustrations are in black-and-white and there are no plates. I feel that some sections like Embryology and Ocular Fundal Changes would be enhanced greatly by colour diagrams and a few good plates. colour or black-and-white.