Nordin-Johansson A, Asplund K
Department of Medicine, University Hospital, Umeâ, Sweden.
J Intern Med. 2000 Jan;247(1):94-104. doi: 10.1046/j.1365-2796.2000.00583.x.
To estimate the proportion of routine clinical interventions in internal medicine that are supported by the results of randomized controlled trials or consensus amongst experienced internists.
Retrospective review of case records allowed one or more major diagnosis-intervention combination(s) to be identified for each patient. The scientific literature was searched for metaanalyses and randomized controlled trials in electronic databases that supported the specific intervention used. When support from randomized trials was lacking, possible consensus on management was sought by asking national expert panels of experienced clinicians.
Department of Medicine at a Swedish teaching hospital.
At total of 197 consecutively admitted medical inpatients.
Fifty per cent of the diagnosis-intervention combinations (186/369) were supported by results from randomized controlled trial evidence and 34% (125/369) were supported by consensus amongst experienced clinicians. The proportion of interventions based on randomised controlled trials was highest in patients with cardiac (64%) and other circulatory diagnoses (73%). There were no important differences between sexes or between age groups.
Half of the interventions used in routine clinical practice amongst medical inpatients are supported by results from randomized controlled trials. These results refute popular claims that only a small proportion of medical interventions are supported by scientific evidence.
评估内科常规临床干预措施中，有多少是得到随机对照试验结果或资深内科医生共识支持的。
通过回顾病例记录进行回顾性研究，确定每位患者的一种或多种主要诊断-干预组合。检索科学文献，查找电子数据库中支持所采用特定干预措施的荟萃分析和随机对照试验。若缺乏随机试验的支持，则通过咨询经验丰富临床医生的国家专家小组来寻求管理方面的可能共识。
瑞典一家教学医院的内科。
共197名连续入院的内科住院患者。
50%的诊断-干预组合（186/369）得到随机对照试验证据的支持，34%（125/369）得到资深临床医生共识的支持。基于随机对照试验的干预措施比例在患有心脏疾病（64%）和其他循环系统疾病诊断的患者中最高（73%）。性别和年龄组之间没有显著差异。
内科住院患者常规临床实践中使用的干预措施，有一半得到随机对照试验结果的支持。这些结果反驳了仅一小部分医学干预措施有科学证据支持的普遍说法。
