Goodin Douglas S
Department of Neurology Room M794, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0114, USA.
J Neurol. 2004 Sep;251 Suppl 5:v50-v56. doi: 10.1007/s00415-004-1508-7.
The use of so-called evidence-based medicine represents a structured way in which to critically assess the medical literature with the goal of defining the value of different therapeutic interventions and, ultimately, improving both physician decision-making and patient outcome. This is not a consensus-based process of the type that has often been employed previously in the development of treatment guidelines. Rather, these assessments involve a series of structured steps. Initially, the specific clinical questions to be answered are defined and the evidence is assembled following a structured literature search. Then, the individual studies are classified as to the quality of the evidence provided, and, finally, using a set of pre-specified rules, this evidence is translated into specific recommendations and conclusions. In this manner, evidence-based medicine can be a very powerful tool for practicing physicians and, consequently, it is important that they become familiar with the fundamentals of this analytical approach. It is the purpose of this manuscript, therefore, to provide an overview of this process using examples from two recently completed assessments on disease-modifying therapies in multiple sclerosis.
使用所谓的循证医学是一种结构化的方法，通过批判性地评估医学文献，旨在确定不同治疗干预措施的价值，并最终改善医生的决策和患者的治疗效果。这不是以往在制定治疗指南时经常采用的基于共识的过程。相反，这些评估涉及一系列结构化步骤。首先，明确要回答的具体临床问题，并通过结构化的文献检索收集证据。然后，根据所提供证据的质量对各项研究进行分类，最后，使用一套预先指定的规则，将这些证据转化为具体的建议和结论。通过这种方式，循证医学可以成为执业医生非常强大的工具，因此，医生熟悉这种分析方法的基本原理很重要。因此，本手稿的目的是通过多发性硬化症疾病修正疗法两项近期完成的评估中的实例，对这一过程进行概述。
