A G Hartzema, M Porta, H H Tilson, editors. (Pp 670; price not stated.) Cincinnati: Harvey Whitney Books, 1998. ISBN 0-929375-18-1.

This book, when initially published in 1988, was intended as an overview of pharmacoepidemiology. Ten years later, the third edition has grown considerably and long gone are the days when it was presented as an introduction to the field of pharmacoepidemiology. The authors have updated existing chapters and expanded the book in many areas. There is now more extensive and in depth discussion of methods, study designs, and statistical analyses used commonly in pharmacoepidemiology. The book has 24 chapters with no special grouping by sections or themes as in a conventional textbook. It covers different aspects of pharmacoepidemiology ranging from drug development procedures to the study of drug effectiveness and drug safety, post-marketing surveillance, pharmacoeconomics, and outcomes research. Three chapters are devoted to sources of data for performing pharmacoepidemiological studies, including automated databases, which are undoubtedly the single major advance in pharmacoepidemiology during the past decade. It also presents extensive information on USA regulations and drug safety monitoring programmes. Three new chapters that focus on specific research areas such as coronary heart disease, psychiatric disorders, and asthma deaths, which will be of special interest to those readers involved in these areas.

The final chapter ends with a comprehensive and useful annotated bibliography on pharmacoepidemiological studies between 1990 and 1996.

The editors fulfil their objective of presenting a wide overview of different topics and from different perspectives (academia, general practice, industry and government), by inviting multiple authors to contribute to the book. Unfortunately, it ends up being a disperse compendium of papers, sometimes with little connection between them. On the other hand, it is helpful that all chapters have their own index and summary that helps the readers decide whether they want to read the full chapter. Numerous tables and figures are included that provide a quick and concentrated illustration of some issues.

The drug approval process, regulatory review and surveillance programmes offers only the USA perspective, and though most principles transcend national boundaries and are applicable worldwide, views from other regulatory agencies would be very welcome.

Although pharmacoepidemiology is defined (2) as the application of epidemiological reasoning, methods and knowledge to the study of the uses and effects of drugs in human populations, the intersection between pharmacoepidemiology and clinical pharmacology (the study of drugs in individuals) is barely touched upon and clearly deserves a more prominent position in a pharmacoepidemiology book.

Chapters including analytical issues are not easy to follow by the reader. As all methods and analytical procedures are common to epidemiology in general, it would be easier to refer the reader interested in these issues to specific epidemiology textbooks.

In summary, this book can be seen as a complementary reading for epidemiologists, researchers, students and individuals with an interest in the field of pharmacoepidemiology.