Borrill Z, Houghton C, Sullivan P J, Sestini P
Department of Cardiorespiratory Medicine, Hope Hospital, Manchester M6 8HD.
BMJ. 2003 Nov 15;327(7424):1136-8. doi: 10.1136/bmj.327.7424.1136.
To determine how many common clinical tests used in a respiratory medicine outpatient clinic are based on high quality evidence.
Retrospective review of case notes. Record of first three tests for each patient. Diagnostic tests, tests used to assess existing condition, explicit trials of therapy were included. Literature search for supporting evidence and grading of best evidence for each test.
Inner city university teaching hospital in the United Kingdom.
All new outpatients referred to a single respiratory medicine team over a period of three months.
Proportion of tests supported by level 1a-1c evidence (scale developed by Centre for Evidence Based Medicine).
Only half the tests that were used to make or exclude a diagnosis and a fifth of the tests used to assess a known condition were supported by level 1a-1c evidence. There was no evidence to support trials of therapy.
A large proportion of clinical tests in respiratory medicine are not supported by level 1a-1c evidence. None of the therapeutic trials that were used were supported by evidence.
确定呼吸内科门诊所使用的常见临床检查中有多少是基于高质量证据的。
病例记录回顾性研究。记录每位患者的前三项检查。包括诊断性检查、用于评估现有病情的检查以及明确的治疗试验。对每项检查进行文献检索以寻找支持证据并对最佳证据进行分级。
英国市中心的大学教学医院。
在三个月期间转诊至单一呼吸内科团队的所有新门诊患者。
由循证医学中心制定的1a - 1c级证据支持的检查比例。
用于做出诊断或排除诊断的检查中，只有一半以及用于评估已知病情的检查中有五分之一得到了1a - 1c级证据的支持。没有证据支持治疗试验。
呼吸内科的大部分临床检查没有得到1a - 1c级证据的支持。所使用的治疗试验均无证据支持。
