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实施科学:从证据到实践。

Implementation science: from evidence to practice.

作者信息

SUáREZ-Obando Fernando, GóMEZ-Restrepo Carlos, BOGOTá SERGíO MARíO Castro-DíAZ

机构信息

Instituto de Genética Humana. Doctorado de Epidemiología Clínica, Departamento de Epidemiología y Bioestadística. Facultad de Medicina, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio.

Doctorado de Epidemiología Clínica, Departamento de Epidemiología y Bioestadística, Facultad de Medicina. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio.

出版信息

Acta Med Colomb. 2018 Oct-Dec;43(4):207-216.

Abstract

The wide range of scientific evidence supporting various clinical interventions is not sufficient for these interventions to be used in practice. For this reason, Evidence-Based Medicine must take the step towards Evidence-Based Practice, through implementation processes that allow deploying and contextualizing the health interventions supported by evidence. For this purpose, the Science of implementation has been developed, which investigates the factors that influence the effective and complete use of scientific innovations in practice, trying to maximize the benefits of health interventions. This science is defined as the study of methods that promote the systematic incorporation of research findings in the clinical routine, with the aim of improving the quality and effectiveness of health services and interventions. The purpose of this article is to introduce the concept of Implementation Science in relation to clinical epidemiology and establish the reasons by which there is an urgent need for its development. In addition, it has the purpose of explaining why the need to accelerate the effective application of Evidence-Based Medicine and define the main models that define the scope of work of this science, including: the particularities of implementation studies, their differences with the classic studies of clinical epidemiology, the implementation and evaluation models, as well as the definition of expected outcomes in an implementation study.

摘要

支持各种临床干预措施的大量科学证据并不足以使这些干预措施在实践中得到应用。因此,循证医学必须通过实施过程迈向循证实践,这些实施过程要能让基于证据的健康干预措施得以部署并适应具体情况。为此,实施科学应运而生,它研究影响科学创新在实践中有效且全面应用的因素,力求使健康干预措施的益处最大化。这门科学被定义为对促进将研究结果系统纳入临床常规的方法的研究,旨在提高卫生服务和干预措施的质量与效果。本文的目的是介绍与临床流行病学相关的实施科学概念,并阐述迫切需要发展这门科学的原因。此外,本文旨在解释为何需要加速循证医学的有效应用,并界定确定这门科学工作范围的主要模式,包括:实施研究的特殊性、它们与临床流行病学经典研究的差异、实施与评估模式,以及实施研究中预期结果的定义。

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