中山大學 循證醫(yī)學evidence based medicine_zsu_fs-全文預覽
【正文】 ? EBM: A Practical Definition – When there is evidence of benefit and value, do it. – When there is evidence of no benefit, harm or poor value, don’t do it. – When there is insufficient evidence to know for sure, be conservative. – And whatever we do, do it right! – David Eddy Definition Clinical expertise 臨床技能 外部證據(jù) External evidences Patient Values and Preferences 病人價值 Clinicians ? Individual clinical expertise – the increasing proficiency and judgement that individual clinicians acquire through clinical experience and clinical practice. Clinicians ? EBM is a Lifelong learning model – lifelong, selfdirected, problembased learning – EBM propose methods to find and evaluate evidence. – EBM converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician’s knowledge base. – Bordley, Clinicians ? The basic for EBM P r o v i d e r U s e r C o n s t r u c t c l i n i c a l q u e s t i o n + + + + + + T a s k P r o v i d e e v i d e n c e C o r r e c t a p p l y o f e v i d e n c e C l i n i c a l p r a c t i c e + + + + + + C l i n i c a l e p i d e m i o l o g y （ D M E ） + + + + Me d i c a l s t a t i s t i c s ++ + M e d i c a l e c o n o m i c s ++ + S o c i a l m e d i c i n e ++ + M e d i c a l i n f o r m a t i c s ++ + G r o u p I n d i v i d u a l Definition Clinical expertise 臨床技能 外部證據(jù) External evidences Patient Values and Preferences 病人價值 External evidences ? Best available external clinical evidence: – clinically relevant research ? basic sciences of medicine ? patientcentred research – External clinical evidence has a short doublingti
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