STATISTICS IN MEDICINE, VOL.
17, 391—393 (1998)
BOOK REVIEWS
Editor: Niels Keiding
1. E. K. ½eargers, R. ¼. Shonkwiler and J. ». Herod, An Introduction to the Mathematics of Biology:
With Computer Algebra Models.
2. Brian ¸. Strom, Pharmacoepidemiology.
1. AN INTRODUCTION TO THE MATHEMATICS OF
BIOLOGY: WITH COMPUTER ALGEBRA MODELS.
E. K. Yeargers, R. W. Shonkwiler and J. V. Herod,
Birkhäuser, Boston, 1996. No. of pages: 433.
Price: DM118. ISBN 0-8176-3809-1
If this review was allowed to consist of only one
word, the word would be: uneven. Apart from the
fact that the book has an uneven number of
authors, an uneven number of chapters and an
uneven number of pages — attributes by themselves
not usually indicative of lesser success — there are
a number of profound problems with ‘unevenness’
that might interest other potential readers.
The authors’ aim is commendable. Their philo-
sophy is that mathematical biology is a discipline
of its own ‘not merely an intrusion of one science
into another’. Therefore, when writing a textbook
for this field one should aim to make it under-
standable for both biologists and mathematicians.
Since biology students usually encounter some
mathematics in their training, but mathematics
students rarely have a biological background, the
authors argue that a textbook like this should
extensively cover biological foundations. In this
they certainly succeed where other textbooks in
mathematical biology that appeared in recent
years have been known to fail. Unfortunately, hav-
ing a lot of biology in a book does not automati-
cally make a good textbook. In fact, the biology in
some chapters is so extensive that it drowns out all
mathematics that comes after. In the last five chap-
ters (of eleven) the balance between biological
background and biomathematics is very uneven.
For example, it is nice to have 35 pages of bio-
chemistry, but not if the only use that is made of
this material is in 14 pages of elementary enzyme
kinetics. I would object equally strongly if some-
one gave 35 pages of mathematical background in
a biomathematics text only to use but a tiny frac-
( 1998 John Wiley & Sons, Ltd.
tion of it in a biological application. The more
biological chapters discuss toxicology, neuro-
physiology, biochemistry of cells, HIV and gen-
etics.
As the subtitle indicates, use is made throughout
the text of computer algebra, Maple to be more
precise. This use is extensive; there are bits of
Maple syntax in virtually every exercise and in
almost all sections of mathematical exposition.
This immediately presents potential readers with
a problem. The authors claim that every lesson is
complete without the use of Maple. This, however,
is not true. In fact, many exercises are such that
without access to and knowledge of Maple they
cannot be completed successfully and — what is
more important — will not provide the intended
insight on the part of the student. Do not take my
word for it; let us look at an example (admittedly
one of the worst examples, so if you think this is
not problematic, you might find the book quite
satisfactory). In Chapter 2 matrices are introduced
for higher-dimensional least squares. The general
problem to calculate vector a from the matrix
equation MTMa"MTy where y is the response
variable, is solved by a"(MTM)~1MTy. This,
however, is not the solution given. Instead we get
two solutions offered for a numerical example, one
using Maple routine ‘fit[leastsquares]’ and one
using seven lines of Maple syntax to do the above
linear algebra. Of course, the students have been
taught about matrix algebra in a previous exercise.
Here’s how that exercise goes:
‘This exercise will review some of the arithmetic of
matrices and vectors.
'with (linalg):
:
'A "matrix([[a, b], [c, d], [e, f ]]);
c "vector([c1.c2]);
:
'evalm(A&*c);’
392 BOOK REVIEWS
One might argue that in these modern times,
students that encounter these problems will end up
solving them by computer anyway, so why teach
them the algebra and analysis to start with?
I would disagree since in my experience more in-
sight and progress is made if the student has a clear
idea of what he or she is doing. I use Maple myself
for all kinds of things and I agree that it is useful to
teach present day students the use of the computer
in the analysis of models, but here an uneven
distribution has been achieved between insight and
computer use. By the way, an uneven use is made
of Maple in another sense. In several chapters,
notably 7, 8, 10 and 11, Maple is used predomi-
2. PHARMACOEPIDEMIOLOGY. Brian L. Strom,
Wiley, Chichester, 1994. No. of pages: 741. Price:
£80. ISBN 047-194-0585
A brief review of current papers in major medical
journals shows a predominance of articles related
to the action of medicines. While the natural venue
of clinical medicine is efficacy testing in clinical
trials, pharmacoepidemiology is concerned with
the effects of medicines as observed in defined
populations. One definition of pharmacoepidem-
iology is therefore the investigation of the effects,
safety and use of medications on a population scale
with the methods of epidemiology. The editor of
this book states in the preface that he considers
pharmacoepidemiology a discipline which applies
the methods of epidemiology to the content area of
clinical pharmacology.
Like the field of pharmacoepidemiology over
the past years, this book has grown considerably in
volume and content since its first edition.1 One of
the two books2 on the market which explicitly
cover the field of pharmacoepidemiology, this
multi-author work is now double its original size
and contains 41 chapters divided into five logical
parts in over 700 pages. The introductory part
describes what pharmacoepidemiology is, what the
study designs and requirements for performing
a study are and gives a brief introduction to the
principles of clinical pharmacology. This section
defines and elaborates the differences between
studies conducted before and after a medication is
placed on the market, providing a brief overview of
basic observational study designs and sample size
considerations, which are central to the pursuit of
Statist. Med., 17, 391—393 (1998)
nantly for numerical solutions of equations and for
plotting.
Summarizing, mathematicians and biologists
with working knowledge of Maple who wish to be
educated in certain parts of biology and computer
use in biomathematics could enjoy this book.
Most others will probably become more irritated
than educated.
HANS HEESTERBEEK
Centre for Biometry Wageningen
P.O. Box 16
6700 AA Wageningen
The Netherlands
associations based on rare adverse events. Closing
with a discussion on when a pharmacoepidem-
iological study becomes appropriate, this part in-
itiates the reader in the basic precepts governing
the field in a very balanced and comprehensive
fashion.
The second part provides the various perspect-
ives of those who might require or themselves
conduct a pharmacoepidemiological study. Repre-
sentatives from academia, industry, and regulatory
authorities present their view of the field and de-
scribe their positions. This part provides impor-
tant background to the very sensitive area in which
pharmacoepidemiologists work, and an insight
into the diverse motivations and interests which
need to be considered when initiating and evaluat-
ing observational research on medicines. The last
chapter of this section focuses on the use of phar-
macoepidemiological data in the courtroom with
numerous illustrative examples. This second part
of the book discusses the perspectives exclusively
from a U.S. based point of view, and will need to be
adapted by readers from other countries to their
own situation.
A profound knowledge of data resources is es-
sential in pharmacoepidemiology, and the third
part of the book deals with these in detail. Signals
which might lead to regulatory action or to phar-
macoepidemiological studies are often derived
from spontaneous reports, that is, case reports or
case series. Spontaneous reporting systems are de-
scribed, again focusing on the U.S. situation, al-
though the chapter on reporting systems outside
the U.S. is very detailed and instructive. It is then
crucial to know the strengths and weaknesses of
( 1998 John Wiley & Sons, Ltd.