循证医学时代:临床专业知识过时了吗?

Y. Balhara, S. Deshpande
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的概念。然而,它在过去20年里表现出指数级的增长,远远弥补了它进入晚的缺点。它由Guyatt等人在20世纪90年代初首创,它代表了在对个体患者的护理做出临床决策时,认真、明确和明智地使用当前最佳证据。虽然是现代的新事物,但它的哲学基础可以追溯到古代的中国。简而言之,循证医学帮助临床医生做出有证据支持的决定。循证医学的哲学可以总结如下:如果有证据表明某样东西是好的,对病人有益,那么就使用它;如果有证据表明某些东西对病人有害,那么就不要使用它。在此背景下,循证实践(EBP)将适用于任何应用来自相关和有效研究的最新信息的实践,这些信息涉及各种诊断测试的有用性或预后因素的预测能力,或特定治疗方法的有益性。多个正在进行的临床试验,越来越多的生物医学期刊和每月发表的数千篇文章确保了信息的泛滥。根据最保守的估计,这一数字在未来几年可能会呈指数级增长。此外,互联网和其他通信方式的日益普及也确保了大多数循证医学的信息时代:临床专业知识过时了吗?
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Era of Evidence Based Medicine: Is Clinical Expertise Outdated?
concept. However, it has more than made up for its late entry by showing exponential growth over the past two decades. Pioneered in early 1990s by Guyatt et al, it represents the conscientious, explicit and judicious use of current best evidence in making clinical decisions about the care of individual patients1. Although new to modern times, its philosophical underpinnings have been traced back to China in older times2 . In simple terms EBM helps the clinicians make decisions supported by evidence. The philosophy of EBM can be summed up as follows: if there is evidence that something is of good and of benefit to the patient, then use it; if there is evidence that something is not good for the patient and can be harmful, then do not use it3. In this context Evidence Based Practice (EBP) would pertain to any practice that applies up-to-date information from relevant and valid research about the usefulness of various diagnostic tests or the predictive power of prognostic factors or the beneficence of a particular treatment method. Multiple ongoing clinical trials, ever increasing number of biomedical journals and thousands of articles published every month have ensured floods of information. Going by most conservative of estimates this is likely to grow exponentially in the coming years. Also growing use of the internet and other modes of communication has ensured that most of this information Era of Evidence Based Medicine: Is clinical expertise outdated?
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