Pientka L, Friedrich C
Medizinisch-Geriatrische Klinik, Augusta-Kranken-Anstalt, Bochum.
Z Gerontol Geriatr. 2000 Apr;33(2):102-10. doi: 10.1007/s003910050166.
The use of evidence-based medicine (EBM) in the field of geriatrics faces some specific problems. Deficits in representation of older people in medical trials and the attitude of the majority of patients and their physicians considering disease as normal aging counteract successful implementation. EBM is also feasible in older patients after some adjustments without dropping the principles of the method or the preferences of patients, thus, resulting in improvement in diagnostic and therapeutic decisions. The methods are exemplified in the use of prophylactic antibiotics in endoscopic gastrostomy, a relevant geriatric problem with practical consequences.
循证医学（EBM）在老年医学领域的应用面临一些特殊问题。老年人群在医学试验中的代表性不足，以及大多数患者及其医生将疾病视为正常衰老的态度，阻碍了循证医学的成功实施。在进行一些调整后，循证医学在老年患者中也是可行的，同时又不放弃该方法的原则或患者的偏好，从而改善诊断和治疗决策。本文以内镜下胃造瘘术中预防性使用抗生素为例，阐述了相关方法，这是一个具有实际影响的老年医学问题。
