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循证医学——我们是否在煮青蛙?

Evidence-based medicine - are we boiling the frog?

机构信息

Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

出版信息

S Afr Med J. 2013 May 28;103(7):447-8. doi: 10.7196/samj.6805.

Abstract

Evidence-based medicine has been defined as 'The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.' There are two major assumptions in this statement. First, it is assumed that the evidence is in fact the best. Unfortunately this is not necessarily so, and published evidence is affected by bias, sponsorship, and blind faith in mathematical probability which may not be clinically relevant. Second, the evidence is population based and may not be applicable to the individual, and blind adherence to this concept may cause harm. We must not abandon clinical experience and judgement in favour of a series of inanimate data points. Medicine is an uncertain science.

摘要

循证医学被定义为“在为个体患者的护理做出决策时,自觉、明确和明智地使用当前最佳证据”。该表述中有两个主要假设。首先,假设证据实际上是最好的。不幸的是,情况并非总是如此,并且已发表的证据受到偏倚、赞助和对数学概率的盲目信任的影响,这些可能与临床无关。其次,证据基于人群,可能不适用于个体,盲目遵循这一概念可能会造成伤害。我们绝不能放弃临床经验和判断,而一味地依赖一系列无生命的数据点。医学是一门不确定的科学。

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