"Aims and Scope - This book aims to provide up-to-date, evidence-based information on the effectiveness and safety of the main complementary and alternative medicines (CAMs). ‘Opinion-based’ recommendations of CAM treatments for different medical conditions (from seven recent, general CAM books) were compared with evidence available from controlled (‘preferably randomised’) clinical trials or systematic reviews. A CD-ROM is included with links to Medline. Summary of Contents – The book is divided into six sections: Section 1: Using the book – This is a useful section, which describes the methods used and how to use each section of the book. Also described are the definitions used for the ‘weight’ of evidence (assessed in terms of level of evidence, methodological quality of the study and volume, ie. number of research studies and their sample sizes) and the ‘direction’ of evidence. Section 2: Diagnostic methods – Includes brief overviews of diagnostic techniques unique to CAM, the principles on which they are based, evidence of scientific validity and risks posed. Section 3: Therapies – Alphabetical ordered therapies are described under the sub-headings of Definition, Related techniques, Background, Traditional concepts, Scientific rationale, Practitioners, Conditions frequently treated, Typical treatment session, Course of treatment, Clinical evidence, Risk-benefit assessment, References. There is a final table on 27 additional therapies ‘without sufficient evidence of effectiveness’. Section 4: Herbal and non-herbal medicine – Alphabetically ordered CAM medications (not vitamin or minerals) described under the sub-headings of Synonyms, Examples of trade names, Source, Main constituents, Background, Traditional Uses, Pharmacologic action, Conditions frequently treated, Clinical evidence, Dosage, Risks, (Contraindications, Precautions/warnings, Adverse effects, Overdose, Interactions, Quality issues) Risk-benefit assessment, References. Section 5: Conditions – Describes 38 medical conditions ‘commonly seen in primary care for which CAM is popular’ and an evidence-based summary of the CAM therapies recommended for each section. Sub-headings within this section are Synonyms, Definition, CAM usage, Clinical evidence, Summary of clinical evidence for condition (as a table), Overall recommendation, References. Section 6: General Topics – Comprises seven separate papers on Canadian, United States and European perspectives on CAM, why patients use CAM and the legal (based on USA law), ethical, general safety and economic issues in CAM. Critique – This is a book for which the medical profession and the general public have been waiting – a comprehensive appraisal of the evidence-based information on CAM. It represents an ambitious project for which the editors are to be commended. The main criticism of the book lies in the lack of high quality research carried out in CAM upon which to base the information. In consequence to this lack of research evidence, CAM practitioners will be disappointed in the very few therapies to be recommended. Although it is emphasised at the beginning of the book that ‘a lack of compelling evidence is not the same as ineffectiveness’, this tenet might easily be missed by the busy GP accessing information on a specific therapy or condition, especially via the CD. Thus, for many therapies, it will be assumed that they are ineffective, whereas the book is only able to present evidence of effectiveness where the research has been performed to a sufficient standard to warrant inclusion. There is particular emphasis on safety throughout the book, to the extent that ‘a treatment is not considered risk free unless evidence suggests otherwise’ – Thus safety is often difficult to report in view of the poor weight of research evidence in CAM. Particularly good are the tables in section 4 outlining toxicity, adverse effects and interactions of herbal and non-herbal medicines as well as the later chapter on general safety issues. The book is damning concerning diagnostic claims of CAM, with the only valid diagnostic method being reported as that of ‘some, but not all’ chiropractic methods. Whilst much effort appears to have been made to ensure objectivity, there was evidence of some inconsistency. One example of this is, for the condition of anxiety, spiritual healing was graded as having a ‘clearly positive’ direction of evidence with a ‘low’ weighting of research evidence. It was however not mentioned as a possible beneficial therapy in the ‘overall recommendation’ paragraph, but massage was considered ‘promising’ although it was stated to have a lesser direction of evidence (‘tentatively positive’) and the same weighting. To include a CD is an excellent idea to increase accessibility to information. It would help to have some documentation on what information is included on the CD. In subsequent versions it is hoped that more medical conditions will be included, as it was disappointing to have such limited evidence available. The tone of the book is that of the objectivity of a scientific textbook, consequently many CAM therapists are likely to feel that their therapy has not been portrayed in a sympathetic light. The ironic tone of many sections, notably the descriptions of scientific rationale, and the book’s overtly reductionist approach might be claimed to misrepresent the holistic nature of many CAM therapies and marginalise the human experience and the potential importance of the therapeutic relationship between practitioner and CAM user. Ultimately, however, users, therapists and healthcare professions want to know which CAM is effective (and which are not) for medical conditions and the most appropriate research methodology to do this is usually the randomised controlled trial. This ambitious book makes great strides to achieve an evidence-based effectiveness guide. The dearth of good quality CAM research as a basis for such evidence has implications for research funding bodies, educationalists, researchers and CAM therapists who need to rise to the challenges of subjecting CAM therapies to appropriate, rigorous, methodological scrutiny. "