Abstract: Beginning with this issue (p 257), wjm will be printing advance excerpts from The Bellevue Guide to Outpatient Medicine—An Evidence-Based Guide to Primary Care, which will be published in book form later this year by BMJ Publishing Group. The guide is a collaborative project involving primary care and specialist attending physicians in the department of medicine at New York University School of Medicine. We hope that it will help teachers, students, and practitioners of primary care in their daily work. In the spirit of evidence-based practice, it presents data about the incidence and prevalence of disease, the accuracy of diagnostic tests, and measures of treatment efficacy in 40 chapters addressing common clinical problems. Advice about patient management is interwoven with annotated references in a novel 2-column format that provides the actual data on which recommendations are based. Readers of the guide are encouraged to use these data to tailor clinical decisions to meet the needs of their individual patients.
The publishing of excerpts from the guide promotes 3 of wjm's objectives. The first is to provide information that is relevant and useful to practicing primary care physicians. The chapters deal with common clinical problems ranging from congestive heart failure to domestic violence and from hyperlipidemia to smoking cessation. Diagnostic, therapeutic, and psychosocial interventions are addressed. The second objective is to link management recommendations to evidence derived from clinical trials in a way that is informative and understandable. Where possible, the guide presents referenced supporting data in proximity to the issues that are being discussed. Strengths and limitations of studies are made explicit. The third objective is to present information in an unbiased manner not unduly influenced by outside sources. Consistent with the philosophy of wjm, the authors and editors of the guide have no financial connection with the pharmaceutic industry. All, in fact, are practicing primary care physicians at Bellevue Hospital Center, New York City, a public institution with a 250-year history of service to the under served.
We hope you find these excerpts useful and interesting and that you will share your responses through our web site (www.bellevuehospitalcenter.org).