中山大學(xué) 循證醫(yī)學(xué)evidence based medicine_zsu_fs(文件)
【正文】 gold standard” for judging whether a treatment does more good than harm. – However, some questions about therapy do not require randomised trials or cannot wait for the trials to be conducted. – Sometimes the evidence we need will e from the basic sciences such as geics or immunology. – And if no randomised trial has been carried out for our patient’s predicament, we follow the trail to the next best external evidence and work from there. 。 Jarvik, Radiology 2022。 ? 2022年 – 上海預(yù)防醫(yī)學(xué)研究院以 Ames試驗和骨髓微核試驗 作了研究，結(jié)果表明中華靈芝寶具有抗突變作用。EvidenceBased Medicine 循證醫(yī)學(xué) 楊 學(xué) 寧 Xuening Yang, MD 廣東省人民醫(yī)院 Guangdong General Hospital 廣東省肺癌研究所 Guangdong Lung Cancer Research Institute 《 循證醫(yī)學(xué) 》 雜志 Journal of Evidencebased Medicine Background ? 1997年 – 上海醫(yī)科大學(xué)中西醫(yī)結(jié)合研究所完成的“中華靈芝寶” 動物實驗 證實：該藥物具有抑瘤作用、保護免疫功能和放化療減毒增效作用。 ? 1999年 – 中國科學(xué)院上海生物研究所丁健研究員等實驗表明，中華靈芝寶（現(xiàn)名：雙靈固本散）能抑制拓?fù)洚悩?gòu)酶 I和拓?fù)洚悩?gòu)酶 II，造成癌細(xì)胞DNA單鏈或雙鏈斷裂，阻斷癌細(xì)胞的無限制繁殖，導(dǎo)致癌細(xì)胞破裂凋亡。 hour – More diasgnostic tools, more drugs, more treatment methods – “Half of what you are taught as medical students will in 10 years have been shown to be wrong. And the trouble is, non of your teachers knows which half.” ? Increasing medical costs ? The patient knows more, and questions more! Background ? Too little time – To keep up to date in Internal Medicine, I need to read 17 articles a day, 365 days a year Background ? False evidence ? Anesthesia and Analgesia – 2022 IF – 2022 Total Cites 15960 Definition ? Evidence Based Medicine – is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. – Sackett, D. L. BMJ 1996 – Evidencebased medicine is the integration of best research evidence with clinical expertise and patient values – Sackett, D. L. 2022 Definition
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