【正文】 ? 1999年 – 中國科學院上海生物研究所丁健研究員等實驗表明，中華靈芝寶（現名：雙靈固本散）能抑制拓撲異構酶 I和拓撲異構酶 II，造成癌細胞DNA單鏈或雙鏈斷裂，阻斷癌細胞的無限制繁殖，導致癌細胞破裂凋亡。s Program in EvidenceBased Care (PEBC) and the Cancer Care Ontario Practice Guidelines Initiative (CCOPGI) Quick Information ? Cochrane Library The Cochrane Collaboration – Systematic reviews – The current resource with the highest methodological 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 – Without the latter, practice risks being rapidly out of date, to the detriment of patients and patientcare.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 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 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 an