Evidence-based medicine in treatment and rehabilitation of spinal cord injured
Evidence-based medicine in treatment and rehabilitation of spinal cord injured
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DOI：
10.1038/sj.sc.3101815
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发表时间：
2005-10-01
期刊：
影响因子：
2.2
通讯作者：
Biering-Sorensen, F
中科院分区：
文献类型：
--
作者：
Biering-Sorensen, F
对循证医学（EBM）的兴趣已经增长，由于大量和指数增长的医学文献发表。EBM是“将最佳研究证据与临床专业知识和患者价值相结合”。循证医学流程的步骤是：(1)将对信息的需求转化为问题；（二）寻找最有力的证据；(3)批判性地评价证据；(4)将批判性评估与临床专业知识和患者独特的生物学、价值观和环境相结合；(5)评价过程，寻求改进效果和效率的方法。在日常临床环境中，重要的是要意识到与证据积累有关的限制以及医疗保健中EBM的使用和可能的误用。对于EMB在脊髓损伤治疗和康复中的应用，MEDLINE因其全面性和最新的维护而成为最敏感的证据来源，而最好的预评价证据来源是Cochrane Library和best evidence。临床实践指南可以很好地总结实际证据。尽管与EMB相关的限制和危险，卫生保健专业人员普遍同意，他们应该努力将循证干预纳入多方面的临床决策过程，包括个体患者的价值观和情况。
The interest for evidence-based medicine (EBM) has grown, due to the enormous and exponentially increasing amount of medical literature published. EBM is 'the integration of best research evidence with clinical expertise and patient values'. The steps in the EBM process are ( 1) convert the need for information into a question; ( 2) find the best evidence; ( 3) critically evaluate the evidence; ( 4) integrate the critical appraisal with clinical expertise and the patient's unique biology, values, and circumstances; ( 5) evaluate the process and seek ways to improve effectiveness and efficiency. Both limitations related to the accumulation of evidence and the use and possible misuse of EBM in the health care are important to be aware of in the daily clinical environment. For use of EMB in treatment and rehabilitation of spinal cord injury MEDLINE is the most sensitive source for evidence due to its comprehensiveness and up to date maintenance, and the best preappraised evidence source is the Cochrane Library and Best Evidence. Clinical Practice Guidelines may provide a good summary of the actual evidence. In spite of limitations and dangers related to EMB, health care professionals generally agree that they should strive to incorporate evidence-based interventions into the multifacetted clinical decision-making process, including the individual patient values and circumstances.