Lode Hartmut, Torres Antoni, Cockle Antony
Institute for Clinical Pharmacology, Charité Universitätsmedizin Berlin, Germany.
Int J Antimicrob Agents. 2007 Feb;29 Suppl 1:S17-22. doi: 10.1016/S0924-8579(07)70006-7.
Physicians' treatment choices are influenced by a number of factors, including guidelines, evidence-based medicine, past experience and, to a certain extent, habit. Evidence-based medicine is the foundation of clinical practice guidelines. This article reviews the influence of evidence and guidelines on physicians' treatment choices. As examples, the role of evidence in guiding treatment decisions in chronic obstructive pulmonary disease is explored, and the impact of guidelines on treatment choices in community-acquired pneumonia is discussed. When choosing the most appropriate treatment for a patient, physicians need to continuously evaluate new evidence, in addition to implementing clinical practice guidelines. Additional factors that should also influence this decision are physicians' prior experience and the individual patient's circumstances.
医生的治疗选择受到多种因素的影响，包括指南、循证医学、既往经验以及在一定程度上的习惯。循证医学是临床实践指南的基础。本文回顾了证据和指南对医生治疗选择的影响。作为示例，探讨了证据在指导慢性阻塞性肺疾病治疗决策中的作用，并讨论了指南对社区获得性肺炎治疗选择的影响。在为患者选择最合适的治疗方法时，医生除了实施临床实践指南外，还需要不断评估新的证据。其他也应影响这一决策的因素包括医生的既往经验和患者的个体情况。
