Bhandari Mohit, Giannoudis Peter V
Division of Orthopaedic Surgery, McMaster University, Hamilton General Hospital, ON, Canada.
Injury. 2006 Apr;37(4):302-6. doi: 10.1016/j.injury.2006.01.034. Epub 2006 Feb 17.
The evidence-based medicine (EBM) related concepts of hierarchy of evidence, meta-analyses, confidence intervals, study design, etc. are nowadays so widespread, that clinicians willing to use today's medical literature with understanding have no choice but to become familiar with EBM principles and methodologies. Although surgeons may perceive that evidence-based medicine mandates a strict adherence to randomised trials, it more accurately involves informed and effective use of all types of evidence (from meta-analysis of randomised trials to individual case series and case reports. With the ever-increasing amount of available information, surgeons must consider a shift in paradigm from traditional practice to one that involves question formulation, validity assessment of available studies and appropriate application of research evidence to individual patients.
如今，循证医学（EBM）中诸如证据等级、荟萃分析、置信区间、研究设计等相关概念广泛传播，以至于那些希望理解并运用当代医学文献的临床医生别无选择，只能熟悉循证医学的原则和方法。尽管外科医生可能认为循证医学要求严格遵循随机试验，但实际上它更准确地涉及明智且有效地运用所有类型的证据（从随机试验的荟萃分析到单个病例系列和病例报告）。随着可用信息的不断增加，外科医生必须考虑从传统实践模式向一种包括问题提出、对现有研究的有效性评估以及将研究证据适用于个体患者的模式转变。
