营养领域循证原则与实践的理念
The Philosophy of Evidence-Based Principles and Practice in Nutrition.
作者信息
Johnston Bradley C, Seivenpiper John L, Vernooij Robin W M, de Souza Russell J, Jenkins David J A, Zeraatkar Dena, Bier Dennis M, Guyatt Gordon H
机构信息
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
出版信息
Mayo Clin Proc Innov Qual Outcomes. 2019 May 27;3(2):189-199. doi: 10.1016/j.mayocpiqo.2019.02.005. eCollection 2019 Jun.
The practice of evidence-based nutrition involves using the best available nutrition evidence, together with clinical experience, to conscientiously work with patients' values and preferences to help them prevent (sometimes), resolve (sometimes), or cope with (often) problems related to their physical, mental, and social health. This article outlines the 3 fundamental principles of evidence-based practice as applied to the field of clinical nutrition. First, optimal clinical decision making requires awareness of the best available evidence, which ideally will come from unbiased systematic summaries of that evidence. Second, evidence-based nutrition provides guidance on how to decide which evidence is more or less trustworthy-that is, how certain can we be of our patients' prognosis, diagnosis, or of our therapeutic options? Third, evidence alone is never sufficient to make a clinical decision. Decision makers must always trade off the benefits with the risks, burden, and costs associated with alternative management strategies, and, in so doing, consider their patients' unique predicament, including their values and preferences.
循证营养学的实践包括运用现有的最佳营养证据，并结合临床经验，认真考虑患者的价值观和偏好，以帮助他们预防（有时）、解决（有时）或应对（通常）与身体、心理和社会健康相关的问题。本文概述了应用于临床营养领域的循证实践的3项基本原则。首先，最佳的临床决策需要了解现有的最佳证据，理想情况下，这些证据将来自对该证据无偏见的系统总结。其次，循证营养学为如何判断哪些证据更或更不值得信赖提供了指导——也就是说，我们对患者的预后、诊断或治疗选择有多确定？第三，仅凭证据永远不足以做出临床决策。决策者必须始终权衡替代管理策略的益处与风险、负担和成本，并在此过程中考虑患者的独特困境，包括他们的价值观和偏好。
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