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Gastroenterology. Electronic Reference and Review
  1. W P GODDARD

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    Gastroenterology. Electronic Reference and Review. Yamada T, Alpers DH, Owyang C, Powell DW, Silverstein FE. (CD-ROM; illustrated; £310.00.) Sacramento, CA: Lippincott-Raven, 1996.

    There are an increasing number of CD-ROMs being peddled in the medical textbook market, either as de novo products of variable quality, or, as in this example, an electronic version of an established textbook. The disk’s contents include not one, but four books. These are verbatim reproductions of the second (1995) edition of Yamada’s textbook of gastroenterology, together with the bonus of the accompanying self assessment question book, the atlas of gastroenterology and its self assessment guide. This certainly represents value for money, saving at least £80 if one was to buy the printed set. There is also a considerable saving in weight (100 g compared with several kilograms), although it does not look quite so impressive sitting on the bookshelf and could easily be mislaid. Of course, one does require a reasonable computer (with 8 megabytes of RAM, 11 megabytes of hard disk space if using Windows) to be free to access the book. This is probably available in most homes, but, given the usual financial constraints, not yet in most gastroenterology departments. However, installation was simplicity itself, and the software ran rapidly on my three year old Macintosh.

    I will not review the textbook itself, as this has previously received favourable comments, with which I concur. I will instead concentrate on the electronic part of this edition.

    Anyone expecting the gastroenterology equivalent of theHitch Hiker’s Guide to the Galaxy may be somewhat disappointed, although at this stage of CD-ROM publishing, also optimistic. The presentation mirrors that of the book, although one views less text per page on a standard monitor. The text is peppered with highlighted links that enable the reader to jump to items of related interest, including references. Luckily you can easily retrace your steps if you have decided to hop around. Tables and figures appear at the side of the screen, and blow up to full size after a short delay. Text and figures can be copied to a printer, and reproduction is very good, even using an inkjet machine. Word searches are certainly more convenient than using the printed index, and the software allows restriction to one or all of the textbooks. However, you may be faced with a long list of (sometimes tenuous) entries if you do not consider your search criteria carefully. These problems will be familiar to anyone who uses Medline or the Internet. One can also annotate the text electronically, which is somehow more acceptable than defacing the printed edition.

    The main problem I have with such CD-ROMs is that their potential is rarely fully realised, which includes this one. Only 55% of the disk space is used, implying that there would be ample space for additional material. Examples could include moving ultrasound images, and videos of procedures such as liver biopsy or endoscopic procedures mentioned in the text. In theory the references could include the whole abstract, copyright permitting. The accompanying self assessment books are weakly interactive: one does not have to look up the answer as it tells you straight away, but I somehow feel a CD-ROM could offer yet more. Again, in theory it could be linked via the Internet to the publisher’s web site for up-to-date amendments. In common with fellow registrars and medical students, I am anxious as to the relative ease of use of CD-ROM text books, and the tiring nature of reading long passages on screen rather than paper.

    I bought this CD-ROM six months ago with my own hard earned cash, and generally have not been disappointed. It has proved invaluable in my own studies, as well as for ideas in teaching undergraduate and postgraduate medicine. I have tested the images on a lecture theatre video projection system with good results, the only problem being that the licence prevents multi-user access (like all computer software one doesn’t actually own the disk or its contents, just permission to use it). These problems aside, I would heartily recommend this CD-ROM to all specialist registrars and gastroenterology departments that do not already own this excellent text, which is as good as any other general gastroenterology textbook, but better value. One cannot exactly leaf through it next to an open fire supping a glass of port, but this is the price of progress I suppose.

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