Evidence Based Medicine and Shared Decision Making: The challenge of getting both evidence and preferences into health care
Evidence Based Medicine and Shared Decision Making: The challenge of getting both evidence and preferences into health care
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DOI：
10.1016/j.pec.2008.07.054
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发表时间：
2008-12-01
影响因子：
3.5
通讯作者：
Barratt, Alexandra
中科院分区：
文献类型：
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作者：
Barratt, Alexandra
循证医学（EBM）和共享医疗决策（SDM）正在改变医疗保健决策的性质。人们普遍认为，卫生保健决策需要综合研究证据和个人偏好。这些方法在疗效（循证实践和共同决策应带来更好的健康结果，并可能带来更具成本效益的卫生保健资源利用）和伦理（在卫生保健中应尊重患者的自主权）两方面都是合理的。然而，尽管这些方法得到了医生和消费者的认可，但在实践中实施仍然有限，特别是在学术和三级保健中心之外。实施方面存在一些实际问题，包括培训、获得研究成果以及开发和获得展示证据和支持决策的工具。也可能存在哲学上的困难，有些人甚至认为这两种方法（基于证据的实践和共同决策）从根本上是不相容的。本文着眼于迄今为止EBM和SDM的成就，它们之间潜在的紧张关系，以及未来的发展趋势。(C) 2008年由爱思唯尔爱尔兰有限公司出版
Evidence Based Medicine (EBM) and Shared Medical Decision Making (SDM)are changing the nature of health care decisions. It is broadly accepted that health care decisions require the integration of research evidence and individual preferences. These approaches are justified on both efficacy grounds (that evidence based practice and Shared Decision Making should lead to better health outcomes and may lead to a more cost-effective use of health care resources) and ethical grounds (patients' autonomy should be respected in health care). However, despite endorsement by physicians and Consumers of these approaches, implementation remains limited in practice, particularly Outside academic and tertiary health care centres. There are practical problems of implementation, which include training, access to research, and development of and access to tools to display evidence and Support decision making. There may also be philosophical difficulties, and some have even suggested that the two approaches (evidence based practice and Shared Decision Making) are fundamentally incompatible. This paper look at the achievements of EBM and SDM so far, the potential tensions between them, and how things might progress in the future. (C) 2008 Published by Elsevier Ireland Ltd.