Lang Britta
Deutsches Cochrane Zentrum, Institut für Medizinische Biometrie und Medizinische Informatik, Universitätsklinikum Freiburg.
Z Evid Fortbild Qual Gesundhwes. 2008;102(1):19-23. doi: 10.1016/j.zgesun.2007.12.016.
There is a considerable amount of uncertainty regarding the care of individual patients. The present paper describes the handling of uncertainties in patient care and its relevance for shared and informed decision-making. What affects the physician-patient relationship, and which strategies may contribute to communicating uncertainties in a constructive manner? Data from clinical trials describe and reduce our knowledge about uncertainty of treatment effects. Regarding rare diseases, however, we are faced with methodological limitations since randomised controlled trials (the highest level of evidence) are not feasible. But other 'low-level' evidence is available and should not be neglected but systematically collected and evaluated as resources for further research activities.
在个体患者的护理方面存在相当多的不确定性。本文描述了患者护理中不确定性的处理及其与共同决策和知情决策的相关性。什么会影响医患关系,哪些策略可能有助于以建设性的方式传达不确定性?临床试验数据描述并减少了我们对治疗效果不确定性的了解。然而,对于罕见疾病,由于随机对照试验(最高证据级别)不可行,我们面临方法学上的局限性。但其他“低级别”证据是可用的,不应被忽视,而应作为进一步研究活动的资源进行系统收集和评估。