De Maeseneer Jan M, van Driel Mieke L, Green Larry A, van Weel Chris
Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium.
Lancet. 2003 Oct 18;362(9392):1314-9. doi: 10.1016/S0140-6736(03)14576-X.
Making evidence from scientific studies available to clinical practice has been expected to directly improve quality of care, but this expectation has not been realised. The notion of quality of care is complex, and quality improvement needs medical, contextual, and policy evidence. In primary care, research is needed that takes into account the specific characteristics of its population and the presentation and prevalence of illness and disease. The context of the doctor-patient encounter plays a major part, and needs better understanding. At the policy level, issues of equity must be addressed. The knowledge base for family practice must be expanded by integration of multiple methods of comprehension, so we can bridge the gap between evidence and practice.
人们期望将科学研究的证据应用于临床实践能直接提高医疗质量,但这一期望尚未实现。医疗质量的概念很复杂,质量改进需要医学、背景和政策方面的证据。在初级保健中,需要开展考虑到其人群的具体特征以及疾病的表现和患病率的研究。医患互动的背景起着重要作用,需要更好地理解。在政策层面,必须解决公平问题。家庭医疗的知识库必须通过整合多种理解方法来扩展,这样我们才能弥合证据与实践之间的差距。