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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.
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This latest edition provides a comprehensive standard reference book of cardiology for the
student and physician alike but is probably lacking in depth for the would-be cardiologist.

Brompton Hospital
London, U.K. David Smith