Tilburt Jon C
Mayo Clinic, Rochester, MN, USA.
J Eval Clin Pract. 2008 Oct;14(5):721-5. doi: 10.1111/j.1365-2753.2008.00948.x.
Evidence-based medicine is being applied to decisions in a range of contexts beyond one-to-one patient care. Yet considerable disagreement persists regarding the defining components of evidence-based decision-making, particularly in institutional and public health contexts.
This article reviews the key elements of evidence-based decision-making for clinical medicine, and adapts those key elements and argues for their broad applicability to a variety of decision-making contexts including institutional, public health, and self-care decision-making contexts.
Conceptual Analysis. Results Evidence based decision-making involves research evidence, "social and institutional circumstances", and "values" of stakeholders. Furthermore, evidence-based decision-making includes "judgment" exercised by experts to appropriately weigh and integrate the various decision-making elements.
Asking critical questions about the purposes and context of a specific decision, basic principles of evidence-based reasoning can be appropriately applied beyond the bedside.
循证医学正被应用于一对一患者护理之外的一系列背景下的决策。然而，对于循证决策的定义要素，尤其是在机构和公共卫生背景下，仍存在相当大的分歧。
本文回顾了临床医学循证决策的关键要素，并对这些关键要素进行调整，论证其在包括机构、公共卫生和自我护理决策背景在内的各种决策背景下的广泛适用性。
概念分析。结果循证决策涉及研究证据、“社会和机构环境”以及利益相关者的“价值观”。此外，循证决策包括专家进行的“判断”，以适当权衡和整合各种决策要素。
通过对特定决策的目的和背景提出批判性问题，循证推理的基本原则可以在床边以外的地方得到适当应用。
