Book Reviews

This CDROM-based tutorial was developed for primary care physicians and staff of Kaiser Permanente (KP) by a team of multimedia designers of the KP California Division to facilitate effective diagnosis and treatment of patients with low back problems. The program combines audio, video, text, and other visual elements in eight modules accessed anytime (by clicking on representative icons located on the left side of the screen): Introduction; Basics; History; Physical Examination; Diagnostic Studies; Diagnosis and Management; When to Refer; and a Case Study of a Patient with a Herniated Disk.

A graphical interface permits users to navigate easily through extensive content to select only the information desired. Program content was developed after scholarly review of recent literature and founded on evidence-based guidelines for best practices as well as on consultation with local and national experts within KP.

Users of this excellent CDROM will be better able to describe the essential anatomy of the lumbar spine; appropriately obtain the medical history and conduct a physical examination for a patient with low back problems; diagnose several common causes of low back problems; arrange appropriate treatment for low back problems of various origins; and refer patients appropriately to specialists. The program's approach addresses not only the physical causes of low back pain but also the psychosocial causes that so often affect patients who are seen for acute and chronic low back pain.

The CDROM disc is accompanied by easily followed instructions written for various platforms--Windows '95, Windows '98, Windows NT, and Macintosh--and provides an enjoyable and most worthwhile learning experience. Clinicians who frequently see patients for low back problems will benefit from the outstanding, clearly presented, comprehensive review of the subject matter. The Kaiser Permanente National CME Program has assigned to this educational activity a maximum of three hours of Category 1 credit toward the AMA Physician's Recognition Award.

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