Evidence based medicine - new approaches and challenges.
Evidence based medicine - new approaches and challenges.
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DOI：
10.5455/aim.2008.16.219-225
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Muhamedagic B
中科院分区：
文献类型：
--
作者：
Masic I;Miokovic M;Muhamedagic B
利益冲突：无申报
循证医学（EBM）是在对个体患者的治疗做出决策时，认真、明确、审慎且合理地运用现代的最佳证据。循证医学将临床经验和患者价值观与现有的最佳研究信息相结合。它是一项旨在在临床决策中增加高质量临床研究应用的运动。循证医学要求临床医生具备新的技能，包括高效的文献检索，以及在评估临床文献时应用正式的证据规则。循证医学的实践是一个终身的、自我导向的、基于问题的学习过程，在这个过程中，对自己患者的治疗产生了对有关诊断、预后、治疗以及其他临床和医疗保健问题的具有临床重要性信息的需求。它不是有配方的“食谱”，但它的良好应用带来了具有成本效益的更好的医疗保健。循证医学与传统医学的关键区别不在于循证医学考虑证据而传统医学不考虑。两者都考虑证据；然而，循证医学要求比传统上使用的更好的证据。循证医学的最大成就之一是系统综述和荟萃分析的发展，研究人员通过这些方法确定关于一个主题的多项研究，筛选出最好的研究，然后对其进行批判性分析，以得出最佳现有证据的总结。未来以循证医学为导向的临床医生有三项任务：a）在临床实践中使用证据总结；b）在其专业领域帮助开发和更新选定的系统综述或循证指南；c）让患者参与医疗实践所依据的治疗、诊断和预后研究。
CONFLICT OF INTEREST: NONE DECLARED Evidence based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information. It is a movement which aims to increase the use of high quality clinical research in clinical decision making. EBM requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning in which caring for one’s own patients creates the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. It is not “cookbook” with recipes, but its good application brings cost-effective and better health care. The key difference between evidence-based medicine and traditional medicine is not that EBM considers the evidence while the latter does not. Both take evidence into account; however, EBM demands better evidence than has traditionally been used. One of the greatest achievements of evidence-based medicine has been the development of systematic reviews and meta-analyses, methods by which researchers identify multiple studies on a topic, separate the best ones and then critically analyze them to come up with a summary of the best available evidence. The EBM-oriented clinicians of tomorrow have three tasks: a) to use evidence summaries in clinical practice; b) to help develop and update selected systematic reviews or evidence-based guidelines in their area of expertise; and c) to enrol patients in studies of treatment, diagnosis and prognosis on which medical practice is based.