Franco G
Dipartimento di Medicine e delle Specialità mediche, Università di Modena e Reggio Emilia, Azienda Ospedaliero, Universitaria Policlinico, Modena, Italy.
G Ital Med Lav Ergon. 2006 Jan-Mar;28(1 Suppl):170-5.
Health care organizations are increasingly aware of the need to apply quality assurance principles to serve their mission and there is an increasing pressure on health professionals to ensure that the practice be based on evidence of appropriateness. Therefore, medical specialists of different disciplines, including occupational health, are presently required to shift from habitual practices to evidence-based practices.
This paper aims at illustrating the opportunity offered by the Evidence Based Medicine (EBM), which can be used in the decision making process of the occupational physician according to the Evidence Based Occupational Health (EBOH) paradigm. The EBOH approach consists of 4 steps (i) the formulation of the problem according to the PICO model, (ii) the search for scientific external evidence based on scientific papers and documents available in different database, (iv) the critical appraisal of such evidence, (v) the application of the evidence in the decision making process.
In spite of some barriers, such as time constraint, which could prevent looking for searchable information, the evidence-based decision-making process should be based on the evidence provided by major resources to answer the question emerging during the practice. Acquiring the skill for information managing facilitates searching appropriate solutions to problems usually met during the professional practice and the adoption of behaviours which will improve the practice.
医疗保健机构越来越意识到需要应用质量保证原则来履行其使命，并且对卫生专业人员的压力也日益增大，要求他们确保实践基于适当性证据。因此，包括职业健康在内的不同学科的医学专家目前都被要求从习惯做法转向循证实践。
本文旨在说明循证医学（EBM）提供的机会，它可根据循证职业健康（EBOH）范式用于职业医生的决策过程。EBOH方法包括4个步骤：（i）根据PICO模型提出问题；（ii）基于不同数据库中可用的科学论文和文献搜索科学外部证据；（iv）对该证据进行批判性评价；（v）在决策过程中应用该证据。
尽管存在一些障碍，如时间限制可能会妨碍寻找可搜索的信息，但循证决策过程应基于主要资源提供的证据，以回答实践中出现的问题。掌握信息管理技能有助于寻找专业实践中通常遇到的问题的适当解决方案，并采用能够改进实践的行为。
