Euler Ulrike, Juche Aaron, Brüggenjürgen Bernd, Kunz Regina, Willich Stefan N
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Klinikum Charité, Humboldt-Universität zu Berlin.
Z Arztl Fortbild Qualitatssich. 2002 Jun;96(5):325-31.
Evidence-based medicine (EBM) is considered complicated and its realization in everyday medical practice causes difficulties. Therefore, in the course of the present study we made each physician of a university hospital the offer that we would undertake for them a systematic search for and critical assessment of the medical literature on a particular patient-related question they might have. One to two weeks after we had supplied our answers, the influence our answers had had on the medical decisions taken and the overall satisfaction with our offer were evaluated using standardized questionnaires.
A total of 34 EBM questions were asked, 31 (91%) of which had a shape that permitted an answer to be obtained. The median time required for supplying an answer was 7 hours (within a range of 3 to 32). In the course of the subsequent evaluation process it was possible to analyze 19 questionnaires (the equivalent of a response rate of 61%). In general our EBM answers were considered good, comprehensible and transparent. For 2/3 of the participants the answers supplied by us satisfied their informational requirements and could be applied satisfactorily in clinical practice.
The offer of external high-quality search-and-assessment of medical literature is useful, but the process is time consuming. Easier access to medical information and knowledge of how to search for and assess literature are important preconditions for the successful implementation of EBM. To achieve the latter evidence-based secondary literature and the development of evidence-based guidelines appear to be reasonable alternatives.
循证医学（EBM）被认为很复杂，在日常医疗实践中实施起来存在困难。因此，在本研究过程中，我们向一家大学医院的每位医生提出，我们将为他们系统地检索和批判性评估与他们可能遇到的特定患者相关问题的医学文献。在我们提供答案一到两周后，使用标准化问卷评估我们的答案对所做出的医疗决策的影响以及对我们提供服务的总体满意度。
总共提出了34个循证医学问题，其中31个（91%）的形式允许获得答案。提供答案所需的中位时间为7小时（范围为3至32小时）。在随后的评估过程中，能够分析19份问卷（相当于61%的回复率）。总体而言，我们的循证医学答案被认为是良好、易懂且透明的。对于2/3的参与者来说，我们提供的答案满足了他们的信息需求，并且可以在临床实践中得到满意的应用。
提供外部高质量的医学文献检索和评估服务是有用的，但这个过程很耗时。更容易获取医学信息以及了解如何检索和评估文献是成功实施循证医学的重要前提。为实现后者，循证二次文献和循证指南的制定似乎是合理的选择。
