Girard F, Empereur F, Guillemin F, Briançon S
SIMES, CHU de Nancy, Hôpital Marin, France.
Therapie. 1998 Nov-Dec;53(6):559-63.
This paper aims to clarify the concepts and terminology of clinical research, evaluation, and quality. Clinical research or clinical epidemiology aims to demonstrate the efficacy of medical care. The optimal methodology is a randomized, double-blind trial that allows a causal inference in respect of efficacy. This should be the first stage before generalization of all medical practice. Evaluation of quality of care aims to verify the effectiveness of medical care by comparing practice with references. The optimal methodology is clinical audit that allows fine-tuned diagnosis of the existence of deviant practices. The analysis of causes and correction of the care process are an integral part of the evaluation work. Thus quality assurance and quality management concepts and methods have been developed which tend to ensure solutions for better care and to maintain the level of quality of care to achieve patient satisfaction. Evaluation, clinical research and management quality could in fact be seen as the complementary facets of a comprehensive approach to quality of care.
本文旨在阐明临床研究、评估和质量的概念及术语。临床研究或临床流行病学旨在证明医疗护理的有效性。最佳方法是随机双盲试验，它能就疗效进行因果推断。这应该是所有医疗实践推广之前的第一阶段。护理质量评估旨在通过将实践与参考标准进行比较来验证医疗护理的有效性。最佳方法是临床审计，它能对异常实践的存在进行精细诊断。对护理过程的原因分析和纠正措施是评估工作不可或缺的一部分。因此，已经形成了质量保证和质量管理的概念及方法，这些方法倾向于确保提供更好护理的解决方案，并维持护理质量水平以实现患者满意度。实际上，评估、临床研究和管理质量可被视为全面护理质量方法的互补方面。
