Haynes R B
Health Information Research Unit, McMaster University Medical Center, Hamilton, Ontario, Canada.
Ann Intern Med. 1990 Nov 1;113(9):724-8. doi: 10.7326/0003-4819-113-9-724.
Many important advances in medical care are first reported in the biomedical literature, but physicians find the literature overwhelming and, therefore, are often unaware of advances. This article examines the ways in which peer-reviewed clinical journals contribute to this problem and proposes some solutions for both their editors and clinical readers. Peer-reviewed clinical journals impede the dissemination of validated advances to practitioners by mixing a few rigorous studies (communications from scientists to practitioners) with many preliminary investigations (communications from scientists to scientists). Journals wishing to improve communication with practitioners should feature rigorous studies of the nature, cause, prognosis, diagnosis, prevention, and treatment of disease and should feature sound clinical review articles (communications from practitioners to practitioners). Additional strategies for improving communication between medical scientists and practitioners include improving publication standards for clinical journals, proving more informative abstracts for clinical articles, fostering the development of derivative literature services, and enhancing practitioners' skills in critically appraising the medical literature.
许多医疗保健方面的重要进展首先在生物医学文献中报道，但医生发现文献数量过多，因此常常对这些进展并不知晓。本文探讨了同行评审临床期刊导致这一问题的方式，并为期刊编辑和临床读者提出了一些解决方案。同行评审临床期刊通过将少量严谨研究（科学家与从业者之间的交流）与大量初步调查（科学家与科学家之间的交流）混在一起，阻碍了经过验证的进展向从业者的传播。希望改善与从业者沟通的期刊应突出对疾病的性质、病因、预后、诊断、预防和治疗的严谨研究，并应刊载可靠的临床综述文章（从业者与从业者之间的交流）。改善医学科学家与从业者之间沟通的其他策略包括提高临床期刊的出版标准、为临床文章提供更具信息性的摘要、促进衍生文献服务的发展，以及提高从业者批判性评估医学文献的技能。
