Towards evidence-based medicine in cardiothoracic surgery: best BETS.
Towards evidence-based medicine in cardiothoracic surgery: best BETS.
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DOI：
10.1016/s1569-9293(03)00191-9
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发表时间：
2003-12-01
影响因子：
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通讯作者：
Mackway-Jones, Kevin
中科院分区：
文献类型：
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作者：
Dunning, Joel;Prendergast, Brian;Mackway-Jones, Kevin
心胸外科医生面临着这样一个两难境地，即许多临床问题在他们的日常实践中并没有得到普遍认可的答案，而患者却越来越多地要求医生提供最佳实践。此外，时间压力意味着临床医生无法跟上已发表的研究的全部内容，而目前为临床医生整理证据的资源几乎没有资源可供心胸外科医生使用。我们采用了急诊医学中首创的一种方法，即最佳证据主题或BestBET。临床医生从他们的日常实践中选择一个突出了一个有争议的领域的临床情景。由此产生了一个由三部分组成的问题，并用于在Medline上搜索相关论文。一旦找到相关论文，就会使用有效的核对表对这些论文进行批判性评价，并对结果进行总结。在这一过程之后，达到了临床的底线。为了增加搜索质量的信心，第二作者，然后是基于证据的杂志俱乐部检查BET，以确保没有遗漏相关证据。然后，这些赌注将在ICVTS网站上发布，供广泛评论。由此产生的赌注，由执业的心胸外科医生撰写，然后将为我们日常实践中提出的重要临床问题提供强有力的循证答案。
Cardiothoracic surgeons are faced with the dilemma that many clinical questions in their daily practice to do not have universally agreed answers, but patients increasingly demand the 'best practice' from their doctors. In addition time pressures mean that clinicians are unable to keep up with the full spectrum of published research and current resources that collate evidence for clinicians have few if any resources for cardiothoracic surgeons. We have adopted an approach pioneered in emergency medicine, namely the Best Evidence Topic or BestBET. Clinicians select a clinical scenario from their daily practice that highlighted an area of controversy. From this, a three-part question is generated and this is used to search Medline for relevant papers. Once the relevant papers are found, these papers are critically appraised using validated checklists and the results are summarized. A clinical bottom line is reached after this process. To add confidence to the quality of the search a second author and then an Evidence Based Journal Club checks the BET to ensure that no relevant evidence is missed. These BETs will then be posted on the ICVTS website prior to publication for widespread commentary. The resulting BETs, written by practising cardiothoracic surgeons, will then provide robust evidence-based answers to important clinical questions asked during our daily practice.