Concato John
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
NeuroRx. 2004 Jul;1(3):341-7. doi: 10.1602/neurorx.1.3.341.
The tenets of evidence-based medicine include an emphasis on hierarchies of research design (i.e., study architecture). Often, a single randomized, controlled trial is considered to provide "truth," whereas results from any observational study are viewed with suspicion. This paper describes information that contradicts and discourages such a rigid approach to evaluating the quality of research design. Unless a more balanced strategy evolves, new claims of methodological authority may be just as problematic as the traditional claims of medical authority that have been criticized by proponents of evidence-based medicine.
循证医学的原则包括强调研究设计的层次结构（即研究架构）。通常，单个随机对照试验被认为能提供“真相”，而任何观察性研究的结果都受到质疑。本文描述了与这种评估研究设计质量的僵化方法相矛盾并令人气馁的信息。除非形成一种更平衡的策略，否则新的方法学权威主张可能会与循证医学支持者所批评的传统医学权威主张一样存在问题。
