Monthly Archives: January 2012

Rao’s Rational Medical Decision Making: Just Right for Med School

Rao's Rational Medical Decision Making: A Case-Based ApproachRao’s Rational Medical Decision Making (MDM): A Case-Based Approach by Lange is a narrative textbook on biostatistics. Chapters include A Brief History Lesson, Biostatistics for Medical Decision Makers, Scientific Approach to Diagnosis, Design of Research to Evaluate Therapies, Understanding the Results of Studies of Therapies, Etiology, Survival, Systematic Reviews, Decision Analysis, and Clinical Practice Guidelines.

Within these chapters is a comprehensive review of biostatistics in an applied fashion.  Whether it’s T-tests or ANOVA or Chi-squared tests, you’ll find realistic applications and examples to help you understand and to fortify your learning.  Even if you plan to do a masters degree in epidemiology or PhD and need in-depth knowledge of statistics, you would still find this book a good starter or review of the main biostatistics concepts with relevant examples.

This book does not take the traditional “textbook” format.  Given that the book takes the narrative format, it does not present information in a bland, isolated manner where synthesis and understanding of the information are secondary to (and seems less important than) information overload.  Rather, Rao’s MDM is a narrative and all the relevant information is presented with equally applicable case examples.  The major concepts, from T-tests to ANOVA to research design are paired with exemplary cases in which Rao helps med students learn biostatistics through realistic and practical examples.

In the narrative format, Rao’s Rational Medical Decision Making is easy to read, easy to understand, and yet still provide all the information you’ll need as a medical student to succeed in biostatistics.  Of course, if you dive below the depth of the main concepts, then you may need help from some supplementary sources. But for the purpose of medical school biostatistics and the USMLE Step 1, this book is perfectly sufficient and is, in fact, quite a comprehensive book for the beginner medical scientist or a great review for the intermediate medical student biostatistician.  The practice questions at the end of each chapter can help any reader solidify concepts and practice real problems.

The downside about this book is that it is not a textbook.  Since it is much more focused on the application of biostatistics, it is less focused on providing every nit-picky detail (in biostatistics in case you are the person who likes to learn everything about everything).  This book also does not go that far in depth for the math genius who wants to learn the theories, derivatives, and fundamental basis of the biostatistics formulas/concepts.  Furthermore, because the book is a narrative, it does not present information in a condensed manner, because interspersed between major and minor concepts are examples that are meant to help explain the application of the concepts.  So if you are looking for a five page hyper-condensed review booklet, this book is not that.

I would definitely recommend Rational Medical Decision Making as it was well written, concise, and relevant, making it an adequately comprehensive starter or review book for biostatistics.


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Grab this FREE copy of First Aid for the USMLE Step 1 2012!

Congratulations to user Buding, an MS-II at Kansas City University of Medicine and Biosciences! He is the winner of the below free copy of First Aid for the USMLE Step 1 2012. This contest is now closed.

First Aid USMLE Step 1 2012 review

We’ve gotten so much traffic and positive interest in our First Aid Step 1 2012 review that we just couldn’t hold onto it. For those of you taking Step 1 closer to the spring, this offer is definitely for you.  All you need to do is to leave your e-mail address in the comments section to win a free copy of First Aid for the USMLE Step 1 2012 (now in full color). You can say whatever you’d like in the comment itself, but the winner of this giveaway will be selected completely at random. We do however request that you click one of the social buttons below, although this is not necessary to win.

Be sure to subscribe to the RSS feed or check back on the site over the next few months as we expand our posts dedicated to Step 1 tips, schedules, calculators, and online applications.

As with previous contests, this is open only to US students, and e-mail addresses are never displayed on the site, used outside of contests, or given away (we’re all med students and understand the value of spam-free inboxes). Limit 1 entry per med student. The contest follows our usual rules and will close in one month, on February 15, 2012, so drop your comments by then.  Good luck!

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What You Need to Know About Lippincott’s Biochemistry

Lippincott Illustrated Reviews BiochemistryBiochemistry can be defined as the study of metabolism, and metabolism is the sum of all chemical reactions in the body. That’s a pretty wide field to cover.  Even if your professors clearly explain what you’re expected to know, there will always be information beyond your curriculum that could help you solidify your knowledge. With biochemistry in particular, you can go in two directions, ‘down’ to the chemistry and energetics (repressed undergrad memories bubbling up) or ‘up’ to the clinical correlations and differentials which we hope to know by the time rotations start. Faced with a bewildering array of review books at every point on this spectrum, you might ask yourself, what is the best book to help me in my class, for the boards, and for the wards?

A common recommendation from biochem professors and older students alike was Harvey and Ferrier’s Biochemistry, part of the Lippincott’s Illustrated Reviews series, now in its 5th edition.  The bulk of the book is a thorough review of proteins, enzymes, and the metabolism of the macronutrients. It describes and comments on important reaction pathways such as glycolysis, the pentose-phosphate pathway, the citric acid cycle, and mechanisms of amino acid synthesis, combination, and degradation. Later in the book, one unit is devoted to integrating these pathways. For example, one chapter looks at the effect on all systems of insulin and glucagon in the fasting and feeding cycle, with chapters covering diabetes, obesity, and nutrition. The last unit covers the special chemistry of genetic information which aims at preserving and expressing information rather than procuring energy or achieving certain concentrations of building block molecules.

My initial look through the book brought an immediate sense of relief. The book seemed organized with a huge number of clear and helpful illustrations. The text itself is succinct but vigorous, like an old-fashioned news anchor might sound if the news of the day for some reason involved the emulsification of dietary lipids. Blocked out in chapters, sections, and subsections, the writing never feels rote or forced but manages to retain a readable, almost “listenable” tone that contrasts favorably to how some other books smother murmur beneath an avalanche of facts. Throughout the text, the authors build on previous topics and indicate points of intersection between pathways, often in the form of strategically placed charts and figures. At the end of every chapter, there is a summary with keywords highlighted, “key concept map” for the chapter, and a few questions and explanations. When that isn’t enough, the thorough index was often handy.

After spending a lot of time with the book, it becomes evident that the editors spent a lot of time designing the reader’s experience. This has the unexpected consequence of making students read more than intended when looking up a particular topic. Often, the next related topic is familiar but not completely solidified. In context, you make a connection you otherwise wouldn’t have, and you can cross one more topic off your list of things to review.

This attention to the reader’s experience is also responsible for what may be the book’s only downside. The details on the diagrams are so focused on making a point that they sometimes have less information than it would appear. In a larger textbook, a chart showing the effect of a drug on blood glucose concentrations over time would probably be large, simple, uncluttered, and accompanied by a lengthy description of the experiment. Here, it is small, marginal, and crowded with word bubbles with arrows overlappingly pointing out features on the graph to which they’re relevant. The effect is that of a comic book: bold, practical, attention-grabbing, but a little bit tiresome all the same.

Nonetheless, this book is very good for its purposes. Though it is an ideal adjuvant to a textbook, it probably is not a substitute for one if you’re being introduced to biochemistry for the first time. Opinions about it for Boards Review are mixed: though it covers all the topics that are likely to come up, some students feel that it is perhaps too thorough for high-yield review. On the other hand, if you use this book during your biochemistry class, you will probably know where to look for what you need to review. Its lucidity and completeness would then be a plus.

Overall, if you’re looking for a book to help you make sense of biochem – to help you know what’s important and give you a sense of how the discipline is used in medicine – Lippincott Biochemistry is highly recommended.


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