Almost two decades ago, Drs. Meyer Friedman and Ray Rosenman de veloped the concept of the Type A coronary-prone behavior pattern and pioneered research in the area. Since then, much effort has been devoted to investigating both medical and psychosocial implications of this phenomenon by an impressive array of biomedical and behavioral scientists. On the basis of the National Heart, Lung, and Blood Institute's (NHLBI) recent Congressional mandate concerning disease prevention and control, the Division of Heart and Vascular Diseases undertook an intensive review of the existing literature in this area. The review underscored that the very nature of the concept of coronary-prone behavior requires examination by researchers from a variety of disciplines. Publication of findings in both the medical and behavioral literature, however, has created difficulties in gaining a truly com prehensive understanding of the total effort in this area. It became obvious that there was no coherent integration of information regarding the strength of the association between behaviors and disease processes (or outcomes), how be havioral factors associated with coronary heart disease were measured, the possible physiological mechanisms mediating the relationship between be havior and disease, whether intervention could be effective, and what forms of intervention appeared most promising. In short, a clear need existed to or ganize this information in a more coherent fashion so that it could be subjected to critical review by members of both the medical and behavioral scientific communities.

In Search of Cornoary-Prone Behavior: Beyond Type A provides a methodology of enormous potential for examining the relationship between behavioral variables and basic pathophysiological mechanisms. They discuss the history of Type-A behavior pattern (TABP) as it relates to coronary heart disease (CHD). Students and researchers with an interest in the correlation between personality and coronary behavior, as well as behavioral medicine, social and health psychology, and the neurosciences.

Cardiovascular disease continues to be the number ioral medicine" was developed and shaped into the one source of morbidity and mortality in our coun­ following definition: try. Despite a 35% reduction since 1964, these Behavioral medicine is the interdisciplinary field con­ diseases, particularly coronary heart disease cerned with the development and integration of behav­ (CHD), claim nearly 1,000,000 lives each year in ioral and biomedical science knowledge and techniques the United States (Havlik & Feinleib, 1979). relevant to the understanding of health and illness and The Framingham study, among others, has iden­ the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation. tified three major risk factors implicated in the de­ (Schwartz & Weiss, 1978) velopment of CHD: smoking, elevated serum cho­ lesterol, and high blood pressure (Castelli et at., This concept of "biobehavioral" collaboration 1986). Given that these factors account for less challenged scientists and clinicians of many disci­ than 50% of the variance associated with CHD plines to consider how they might more effectively (Jenkins, 1976), it has become obvious that addi­ develop diagnostic, treatment, and prevention tional risk factors must be identified if further pro­ strategies by merging their perspectives to address gress is to be made in disease prevention and simultaneously, among others, behavioral, psy­ control.

Despite medical technological advances, the major killers with which we must currently contend have remained essentially the same for the past few decades. Stroke, cancer, and heart disease together account for the vast majority of deaths in the United States. In addition, due to improved medical care, many Americans who would previously have died now survive these disorders, necessitating that they receive appropriate rehabilitation efforts. One result of our own medical advances is that we must now accept the high costs associated with providing quality care to individuals who develop one of these problems, and we must avail ourselves to assist of afflicted individuals. families Despite the relative stability of causes of death and disability, the health-care field is currently experiencing tremendous pressures, both from professionals with in the field, who desire more and better technology than is currently available, and from the public and other payers of health care (e.g., insurance companies), who seek an end to increasing health-care costs. These pressures, along with an increased emphasis on providing evidence of cost-effectiveness and quality assurance, are substantially changing the way that health-care professionals perform their jobs.

Provides a comprehensive overview of epidemiologic, experimental, and clinical data evidencing the emergence of cardiac psychology as a specialty. It offers a thorough and up-to-date review of the scientific research supporting the relationship between cardiac disease and psychological condition, practical suggestions for developing a clinical practice and directions for future research in this new field of "cardiac psychology". The first part provides an overview of the psychological risk factors for cardiac disease. Emphasis is placed on physiological basis of mind-heart link, depression and anxiety, personality and relational aspects, and on advanced statistical tools for the study of personalities at risk. The second part offers a systematic overview of literature on psychological treatments in cardiac rehabilitation.

Meyer Friedman, the physician who first identified Type A behavior (TAB), here offers a full description of the most effective way to correctly diagnose it. This guidebook offers a step-by-step description of his revolutionary method that has proven successful in treating thousands of TAB sufferers, in many cases, alleviating it completely. A truly unique resource, Type A Behavior features drawings and photographs illustrating the psychomotor signs of TAB. A special appendix lists a series of quotations found especially useful for changing some of the false belief systems held by TAB subjects.

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.