The Bedford Murder: an Evidence-Based Clinical Mystery.

The Bedford Murder: An Evidence-Based Clinical Mystery Godwin M, Hodgetts G. Philadelphia, PA 19106, Hanley & Belfus Inc, 2003, paperback, 200 pp, ISBN: 1-56053-565-2, $21.95.

The Bedford Murder is an interesting introduction to the use of evidence in clinical practice. The authors combine a murder mystery with a clinical text on evidence-based practice.

The plot of the murder mystery (which the authors claim is based on a real homicide case) involves all the best that mystery and real life have to offer: infidelity, jealousy, greed, and deception. The plot could easily be taken from an episode of Columbo or Murder She Wrote. The action takes place in Bedford, a small town in Massachusetts, and the authors have included characters such as physicians, pool-hall characters, secretaries, wealthy business tycoons, and their families. The authors cleverly weave the characters in and out of the plot, and in and out of each other's lives. Because Bedford is a small town, the physician protagonist has interactions with most of its residents. The physician (Dr Sharp) gets to help the local sheriff solve the mystery surrounding the discovery of a dead body in the trunk of an influential resident's car.

Each chapter of the text is a description of a clinical encounter experienced by Dr Sharp. At the end of each chapter, the authors present several questions related to the encounter. These questions are of five types: diagnosis, therapy, harm, prognosis, and etiology. Following the questions, the authors present several critically appraised articles and guide the reader to some logical solutions to these questions. Finally, the authors make the clinical decision for Dr Sharp, based on the evidence presented, and relate the clinical encounter to the homicide case.

As the story unfolds, the reader will recognize instances of possible breaches in ethical behavior on Dr Sharp's part, such as not informing a patient she had a sexually transmitted disease or disclosing confidential information. The authors do not formally address these issues in their book; instead they focus on evidence-based decision making.

The vast majority of the clinical questions addressed in The Bedford Murder deal with potential questions readers might encounter in a primary medical practice rather than in a physical therapy practice. This book, however, does get the message across that clinicians can find the answer to most clinical questions from the literature ... if they look for them.

In conclusion, I enjoyed reading The Bedford Murder. Although this book lays out the model of clinical decision making based on evidence, I do not necessarily suggest it as mandatory reading for physical therapists. There are probably more appropriate books for those in the physical therapy profession. Having said that, if a physical therapist has 2 hours in an airport, reading The Bedford Murder would be time well spent.

Joseph Lucca, PT, PhD, GCS 

University of Delaware 

Newark, Del

Dr Lucca is Associate Professor in the Department of Physical Therapy. He teaches classes on "Physical Therapy as a Profession," "Research Methods, " "Psychosocial Development, " "Geriatrics, "and "Life Span Development."