Mellis Craig
Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2015 Jan;51(1):65-8. doi: 10.1111/jpc.12800. Epub 2014 Dec 24.
Although the phrase 'evidence-based medicine' (EBM) was used for the first time in the medical literature less than 25 years ago, the history of EBM goes back for centuries. What is remarkable is how popular and how globally accepted the EBM movement has become in such a short time. Many famous, past clinicians have played major roles in the disciplines that preceded EBM, particularly 'clinical epidemiology'. It soon became clear to the early EBM champions that 'evidence' was only part of the clinical decision-making process. Consequently, both clinical expertise and the patient's values and preferences were rapidly incorporated into the concept we now know as 'EBM'. The current need for high-quality, easily accessible 'evidence-based summaries' for busy clinicians is now apparent, as traditional EBM requires both considerable time and skill. Consequently, there is a progressive move away from the primary literature (such as randomised controlled trials) to systematic reviews and other 'evidence-based summaries'. The future of EBM will almost certainly involve widespread utilisation of 'clinical (computer)-based decision support systems'.
尽管“循证医学”（EBM）这一术语在医学文献中的首次使用还不到25年，但循证医学的历史可以追溯到几个世纪以前。值得注意的是，循证医学运动在如此短的时间内就变得如此流行并在全球范围内被接受。许多过去著名的临床医生在循证医学之前的学科，特别是“临床流行病学”中发挥了重要作用。早期的循证医学倡导者很快就清楚地认识到，“证据”只是临床决策过程的一部分。因此，临床专业知识以及患者的价值观和偏好很快就被纳入了我们现在所知的“循证医学”概念中。由于传统的循证医学既需要大量时间又需要专业技能，现在忙碌的临床医生对高质量、易于获取的“循证医学总结”的需求显而易见。因此，正逐渐从原始文献（如随机对照试验）转向系统评价和其他“循证医学总结”。循证医学的未来几乎肯定会涉及“基于临床（计算机）的决策支持系统”的广泛应用。
