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Handbook of Neurologic Rating Scales.

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    Handbook of Neurologic Rating Scales.Edited by robert m herndon (Pp 276, US$125). Published by Demos Vermande, New York, 1997. ISBN 1-888799-07-2.

    This well produced book joins a small group of books which actually show some of the measures now used in clinical research. There are many, many measures, and each book can only show a selection. This book would be helpful to anyone who is interested in learning about measures of disease severity and outcome, although it might not be the best in any particular circumstance.

    Everyone should read the introduction to this book, written by Dr Herndon. It is full of common sense. It also emphasises the most important point of all, and I repeat it here: “.. the most important question in designing or choosing a scale is how well it is suited to the task at hand in terms of validity, efficiency, sensitivity and specificity ... ”. If only every researcher would read, remember, and act on this one statement then neurological research would advance greatly.

    The book is then primarily structured around diseases. This is useful to anyone interested in a specific disease, but means that many non-specific areas of measurement are not covered. The chapters cover most of the common and important neurological diseases: multiple sclerosis; amyotrophic lateral sclerosis; head injury; stroke; movement disorders including Parkinson’s disease; epilepsy; and dementia. Many of the chapters follow a similar layout, but there are exceptions. Most seem to be written by people who have direct experience of the scales, and indeed there is much original and useful data relating to the assessment of progression in motor neuron disease in that chapter. There are two more general chapters. The first covers paediatric developmental scales, and I think that this is the only similar book to cover this area. The second covers the measurement of the outcome from rehabilitation. The best chapters are those covering multiple sclerosis, amyotrophic lateral sclerosis, movement disorders, and dementia. The chapter on stroke is much less comprehensive, and contains some errors in references (for example, to the Hamrin ctivity Index), and the chapter on head injury stands out as containing much less useful information.

    The book gives considerable useful information about many of the scales mentioned, and certainly would help anyone who was unfamiliar with the field. The references are reasonable, although sometimes inaccurate and quite often statements are made without reference, which can be irritating especially as references do exist to support most statements. Overall this book is good, and complements the other books available well. It will be especially helpful to those interested in the current “hot” diseases, multiple sclerosis, amyotrophic lateral sclerosis, and Parkinson’s disease.

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