Despite the book’s title, it is not a book about decision making in child and adolescent medicine. There is little analysis of the way clinical decisions are made in paediatrics. There is no analysis of the balancing of evidence from adults and knowledge of differences in childhood physiology, nor the more complex processes of negotiating decisions when the physician, child, and family are not completely concordant.

This book is a compendium of problem based management pathways. It is by no means a pocket companion either. At 895 printed pages and 2.31 kg it could easily hold open a recalcitrant coffee room door—and covers common and uncommon problems in paediatric primary and secondary care. The book is extensive in coverage and although it contains a number of chapters of particular relevance to US paediatricians (for example, insurance problems for the child with special health care needs), the content is largely applicable to general paediatrics the world over. The style is easy to read and diagrams of the flow of clinical thought are extremely clear.

But I wonder who will use this book. I imagine the average general paediatric junior trainee will find this book too heavy and expensive; there are more useful pocket books in general circulation. The middle grade will be interested by the approach to uncommon problems, but desire further detail and be forced to return to other sources. Senior clinicians have (probably) developed their own approach to the problems presented. Where such a compendium could be useful would be if it was clearly based on the best available evidence. In this way it would provide a starting point to modify current practice and produce local guidelines. Although each chapter does have references, there is no mention of the quality of study or the strategy used to search for and appraise the information

Among the books which assist paediatricians in everyday practice, this one does not stand out for me.