Uhl W, Wente M N, Büchler M W
Klinik für Viszerale und Transplantationschirurgie, Universitätsklinik Bern, Inselspital, Schweiz.
Chirurg. 2000 Jun;71(6):615-25. doi: 10.1007/s001040051113.
The employment of the optimal therapeutic option according to the best current knowledge is called evidence-based medicine (EBM). Moreover, considering the cost explosion in public health systems, EBM should contribute towards economical and targeted use of the restricted resources and towards quality assurance in medicine. Obviously, this is applicable to the operative specialties and can be termed as evidence-based surgery. Surgeons have to do their "homework" about this subject and to perform randomized controlled trials (the gold standard with the greatest evidence) on a large scale, in order to come up to this expectation in future. Evidence-based therapy is essential for the preservation and especially for the further development and evolution of high-quality surgery with, at the same time, quality assurance in the new millenium. This article presents the definition of EBM and its implication in the operative fields. Fundamental principles for the practical conduct of clinical randomized controlled trials are defined and the specific problems in surgery are discussed.
根据当前最佳知识运用最佳治疗方案被称为循证医学（EBM）。此外，鉴于公共卫生系统中的成本激增，循证医学应有助于经济且有针对性地使用有限资源，并有助于医学领域的质量保证。显然，这适用于外科手术专业，可称之为循证外科。外科医生必须就这一主题做好“功课”，并大规模开展随机对照试验（最具证据的金标准），以便在未来达到这一期望。循证治疗对于高质量外科手术的保存，尤其是进一步发展和演进至关重要，同时也是新千年质量保证的关键。本文介绍了循证医学的定义及其在手术领域的意义。定义了临床随机对照试验实际操作的基本原则，并讨论了外科手术中的具体问题。
