Ashby D, Smith A F
Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Stat Med. 2000 Dec 15;19(23):3291-305. doi: 10.1002/1097-0258(20001215)19:23<3291::aid-sim627>3.0.co;2-t.
We review two recent trends: the emergence of evidence-based medicine and the growing use of Bayesian statistics in medical applications. Evidence-based medicine requires an integrated assessment of the available evidence, and associated uncertainty, but there is also an emphasis on decision-making, for individual patients, or at other points in the health-care system. This demands consideration of the values and costs associated with potential outcomes. We argue that the natural statistical framework for evidence-based medicine is a Bayesian approach to decision-making that incorporates an integrated summary of the available evidence and associated uncertainty with assessment of utilities. We outline a practical agenda for further development.
循证医学的兴起以及贝叶斯统计学在医学应用中的日益广泛使用。循证医学要求对现有证据以及相关不确定性进行综合评估，但同时也强调针对个体患者或医疗保健系统其他环节进行决策。这需要考虑与潜在结果相关的价值和成本。我们认为，循证医学的自然统计框架是一种贝叶斯决策方法，它将现有证据和相关不确定性的综合总结与效用评估相结合。我们概述了进一步发展的实际议程。
