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  Vol. 121 No. 6, June 1986 TABLE OF CONTENTS
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Decision Making in Gastroenterology

by J. S. Levine, 378 pp, Burlington, Ontario, BC Decker, 1985.

DAVID FROMM, Reviewer
Syracuse, NY

Arch Surg. 1986;121(6):732.

Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Decision Making in Gastroenterology is a book of annotated algorithms. The author has given a great deal of thought to the structure of these well-conceived decision trees. Numerous gems and a few excellent references are found in the annotations. While the algorithmic method has worked well in the operation and repair of mechanical devices, there are major shortcomings in clinical medicine if too much reliance is placed on this highly structured approach.

Decision Making in Gastroenterology oversimplifies complexities and indicates neither which steps are critical nor at what point a decision is crucial. For example, it has not been shown that a nasogastric tube is essential for the successful treatment of pancreatitis, yet the book states I should use such a tube for severe (but not mild) pancreatitis. It goes on to suggest that I can only determine the severity of the pancreatitis by doing laboratory studies. This approach not . . . [Full Text PDF of this Article]



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