研證復康論文 / EBM Articles


研證醫學

循證醫學(EBM)是認真、明確、明智和合理地使用現代最佳證據來决定對個別患者的護理。循證醫學將臨床經驗和患者價值與最好的研究資訊結合起來。這是一項旨在提高高品質臨床研究在臨床決策中的應用的運動。循證醫學需要臨床醫生的新技能,包括有效的文獻檢索,以及在評估臨床文獻時應用正式的證據規則。循證醫學的實踐是一個終身的、自我指導的、以問題為基礎的學習過程,在這個過程中,照顧自己的病人產生了對診斷、預後、治療和其他臨床和保健問題的重要臨床資訊的需求。它不是食譜的“食譜”,但它的良好應用帶來了成本效益和更好的保健。循證醫學與傳統醫學的主要區別不在於循證醫學考慮證據而傳統醫學不考慮證據。兩者都考慮了證據;然而,循證醫學需要比傳統使用的更好的證據。循證醫學最偉大的成就之一是發展了系統綜述和薈萃分析,研究人員通過這些方法確定一個主題的多個研究,分離出最好的研究,然後對它們進行批判性分析,總結出最佳可用證據。面向循證醫學的未來臨床醫生有三項任務:a)在臨床實踐中使用證據總結;b)幫助製定和更新其專業領域內選定的系統評估或循證指南;c)讓患者參與醫療實踐所依據的治療、診斷和預後研究。

Evidence based medicine

Evidence based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information. It is a movement which aims to increase the use of high quality clinical research in clinical decision making. EBM requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning in which caring for one’s own patients creates the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. It is not “cookbook” with recipes, but its good application brings cost-effective and better health care. The key difference between evidence-based medicine and traditional medicine is not that EBM considers the evidence while the latter does not. Both take evidence into account; however, EBM demands better evidence than has traditionally been used. One of the greatest achievements of evidence-based medicine has been the development of systematic reviews and meta-analyses, methods by which researchers identify multiple studies on a topic, separate the best ones and then critically analyze them to come up with a summary of the best available evidence. The EBM-oriented clinicians of tomorrow have three tasks: a) to use evidence summaries in clinical practice; b) to help develop and update selected systematic reviews or evidence-based guidelines in their area of expertise; and c) to enrol patients in studies of treatment, diagnosis and prognosis on which medical practice is based.