Donner-Banzhoff Norbert
Abteilung für Allgemeinmedizin, Präventive und Rehabilitiative Medizin, Philipps-Universität Marburg, Karl-von-Frisch-Str. 4, 35043 Marburg.
Z Evid Fortbild Qual Gesundhwes. 2010;104(8-9):648-52. doi: 10.1016/j.zefq.2010.09.026. Epub 2010 Oct 14.
Evidence-based medicine (EBM) is closely linked to clinical epidemiology. EBM itself, however, is not a science but a framework bridging science and the world of decision-making. To this purpose EBM makes use of clinical studies which have direct implications for patient care but constitute only a small part of the total medical research enterprise. EBM is, more or less, invariant to philosophical schools. Rather, it is a pragmatic approach to filter scientific results through commonly accepted validity criteria. There is no objective theoretical justification for doing so. EBM has been successful because clinicians and stakeholders with opposing interests use the results of clinical studies as an arbiter for decision-making at all levels. The development of therapeutic, but also of information and communication technologies has contributed to the rise of EBM. Finally, variations in care being demonstrated in multiple studies have changed the relationship between health professionals and society. EBM can be understood as a reaction to this change in the societal environment.
循证医学（EBM）与临床流行病学密切相关。然而，循证医学本身并非一门科学，而是一个连接科学与决策领域的框架。为此，循证医学利用对患者护理有直接影响的临床研究，但这些研究仅占整个医学研究事业的一小部分。循证医学或多或少不受哲学流派的影响。相反，它是一种务实的方法，通过普遍接受的有效性标准来筛选科学成果。这样做并没有客观的理论依据。循证医学之所以成功，是因为利益相悖的临床医生和利益相关者将临床研究结果用作各级决策的仲裁者。治疗技术以及信息和通信技术的发展推动了循证医学的兴起。最后，多项研究表明的护理差异改变了卫生专业人员与社会之间的关系。循证医学可以被理解为对社会环境这一变化的一种反应。
