Vrdoljak Davorka
Department of Family Medicine, University of Split, School of Medicine, Soltanska 2, Split, Croatia.
Acta Med Acad. 2012;41(1):88-92. doi: 10.5644/ama2006-124.42.
The concept of evidence based medicine (EBM) as the integration of clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP) in a short time is not easy. Five useful steps are described- represented by the acronym 5A+E: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search on the spot is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GPs office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty) by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning.
EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GPs everyday work is becoming a part of everyday practice.
循证医学（EBM）的概念，即临床专业知识、患者价值观与最佳证据的整合，是由大卫·萨克特在20世纪80年代提出的。医学领域的科学文献往往具有内容扩充、不断积累且迅速过时的特点。阅读所有重要文章以跟上相关信息是不可能的。在短时间内找到能回答全科医学（GP）临床问题的最佳证据并非易事。文中描述了五个有用的步骤，首字母缩写为5A + E：评估、提问、获取、评价、应用和评估。建议养成当场进行证据检索的习惯。尽管斯普利特医学院的医学生从学习的第一天起就在所有课程中学习循证医学，但他们在实际面对真实患者时进行证据检索和批判性评价证据的经验并不充足。向即将毕业的学生教授循证医学在全科医生办公室的实际应用有所不同，且对他们的职业发展可能具有重要作用。通过养成持续查证证据的习惯，这会对他们未来在家庭医学（或其他医学专业）工作的质量产生积极影响，从而确保最佳实践成为终身学习的一种机制。
循证医学是医学各分支的基石，也是作为一门科学和专业学科的家庭医学的重要组成部分。让全科医生的日常工作得出循证答案正成为日常实践的一部分。
