Buetow S, Kenealy T
Department of General Practice and Primary Health Care, University of Auckland, New Zealand.
J Eval Clin Pract. 2000 May;6(2):85-92. doi: 10.1046/j.1365-2753.2000.00237.x.
Evidence is defined by its ability to establish or support conclusions. Evidence-based medicine (EBM) equates evidence with scientific evidence and views factors such as clinical expertise as important in moving from evidence to action. In contrast, we suggest that EBM should acknowledge multiple dimensions of evidence including scientific evidence, theoretic evidence, practical evidence, expert evidence, judicial evidence and ethics-based evidence. What EBM loses by not acknowledging these dimensions as evidence is the ability, among other things, to make and defend judgements based on understandings that complement science and are no less important than those science can offer. We argue for a new definition of EBM that, without forced accommodation or unacceptable compromise, acknowledges dimensions of evidence produced within and outside science.
证据是由其确立或支持结论的能力所定义的。循证医学（EBM）将证据等同于科学证据，并认为诸如临床专业知识等因素在从证据转化为行动的过程中很重要。相比之下，我们认为循证医学应该承认证据的多个维度，包括科学证据、理论证据、实践证据、专家证据、司法证据和基于伦理的证据。循证医学不承认这些维度为证据所失去的，除其他外，是基于补充科学且与科学所能提供的理解同样重要的理解来做出和捍卫判断的能力。我们主张对循证医学进行新的定义，即在不强行迁就或做出不可接受的妥协的情况下，承认科学内外产生的证据维度。
