中山大學循證醫(yī)學evidencebasedmedicine_zsu_fs-wenkub
2023-03-08 15:24:01 本頁面
【正文】 dological rigor – For each clinical question, all of the English literature meticulously searched for randomized trials – Large systematic reviews with valid methods + collaborative effort – Conclusions are based on all the evidence from valid randomized trials PDQ (Physician Data Query) mation/pdq/ Clinical Trial Database ? Current Controlled Trials ? NIH PubMed /MEDLINE ? Evidencebased Medicine ? Bases action on best evidence synthesis ? Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. – Without the former, practice risks being evidencetyrannised, for even excellent external evidence may be inapplicable or inappropriate for an individual patient. – Without the latter, practice risks being rapidly out of date, to the detriment of patients and patientcare. Definition Clinical expertise 臨床技能 Patient Values and Preferences 病人價值 外部證據(jù) External evidences The Patients ? Individualize 個體化； ? Compliance 依從性； ? Informed consent 知情同意 ? Value …… Definition Clinical expertise 臨床技能 Patient Values and Preferences 病人價值 外部證據(jù) External evidences Other factors insurance …… What EBM is Not ? EBM is not cookbook medicine – Evidence needs extrapolation to the patient’s unique biology and values – EBM requires that the best external evidence be integrated with individual clinical expertise and patientchoice in a bottomup approach. – External clinical evidence can inform, but can never replace, individual clinical expertise. ? EBM is not costcutting medicine – when efficacy for the patient is paramount, costs may rise, not fall What EBM is Not ? EBM is not restricted to randomised trials – The randomised trial and systematic review are the “
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