Nordin-Johansson A, Asplund K
Medicinkliniken, Norrlands Universitetssjukhus, Umeå.
Lakartidningen. 1999 Jun 30;96(26-27):3173-6.
In a series of 197 consecutive patients admitted to a department of medicine, the scientific basis of major interventions was evaluated by comparison with corresponding data in published reports of randomised controlled trials (RCTs) or, if no such data were available, according to the consensus of a panel of experienced consultants in internal medicine. Of the 369 major interventions (including expectant management) in the series, 50 per cent were judged according to RCTs and 34 per cent according to panel consensus, no authoritative support being available in the remaining 16 percent of cases. Intervention consistent with corresponding RCT data was somewhat more common in the under 70 than in the over 70-year-old age subgroup of patients, but there was no such difference between male and female subgroups. Among the various specialties and subspecialties, support from RCTs was available for the majority of interventions in cardiology, stroke/angiology and gastroenterology, where-as support from the panel was available for the majority of interventions in endocrinology, nephrology, haematology, and oncology. Regarding the management of patients presenting with symptoms only, without a specific diagnosis, no support was available from RCTs and little consensus among the panel.
在一个内科收治的197例连续患者系列中，通过与随机对照试验（RCT）发表报告中的相应数据进行比较，或在无此类数据时，依据一组经验丰富的内科顾问的共识，对主要干预措施的科学依据进行了评估。在该系列的369项主要干预措施（包括观察性处理）中，50%是根据RCT判断的，34%是根据专家小组共识判断的，其余16%的病例没有权威性支持。与相应RCT数据一致的干预措施在70岁以下患者亚组中比在70岁以上患者亚组中更为常见，但在男性和女性亚组之间没有这种差异。在各个专科和亚专科中，RCT对大多数心脏病学、中风/血管病学和胃肠病学干预措施提供了支持，而专家小组对大多数内分泌学、肾脏病学、血液学和肿瘤学干预措施提供了支持。对于仅表现出症状而无特定诊断的患者的处理，RCT没有提供支持，专家小组之间也几乎没有达成共识。
