Trüeb Ralph M, Jolliffe Vicky M L, Régnier Antonia Fellas, Dutra Rezende Hudson, Vañó-Galván Sergio, Kopera Daisy, Ioannides Demetrios, Gavazzoni Dias Maria Fernanda Reis, Macpherson Melanie, Gadzhigoroeva Aida, Ovcharenko Julya, Lee Won-Soo, Murugusundram Sundaram, Kurata Sotaro, Chang Mimi, Tanglertsampan Chuchai
Center for Dermatology and Hair Diseases Professor Trüeb, University of Zurich, Zurich, Switzerland.
The Royal London Hospital, London, United Kingdom.
Skin Appendage Disord. 2019 Nov;5(6):338-343. doi: 10.1159/000500364. Epub 2019 Aug 20.
Evidence-based medicine (EBM) aims for the ideal that healthcare professionals make conscientious, explicit, and judicious use of the best available evidence gained from the scientific method to clinical decision-making. It seeks to assess the strength of the evidence for benefits of diagnostic tests and treatments, using techniques from science, engineering, and statistics, such as the systematic review of medical literature, meta-analysis, risk-benefit analysis, and randomized controlled trials. The limited success rate of EBM therapies suggests that the complex nature of hair loss may be inadequately served by the present levels of evidence, and that physicians treating hair loss may have fallen short of adequately researching a robust evidence to underpin their practices. Against this backdrop, the concept of precision medicine (PM) is evolving. PM refers to the customization of medical care to the patient's individual characteristics based on the patient's genetic background and other molecular or cellular analysis, while classifying patients into subpopulations that differ in their susceptibility to a particular medical condition, in the biology or prognosis of those medical conditions, or in their response to a specific treatment. With the advances in hair research, the powerful tools of molecular biology and genetics, and innovative technologies, we have the robust scientific data and tools to adapt the concept of PM to the practice of trichiatry. Finally, databases pertaining to the development and efficacy of PM must be analyzed and be used to form the basis of evidence-based personalized trichiatry.
循证医学（EBM）旨在实现这样一个理想，即医疗保健专业人员在临床决策中认真、明确且审慎地运用从科学方法中获得的最佳现有证据。它试图运用科学、工程和统计学的技术，如医学文献的系统综述、荟萃分析、风险效益分析和随机对照试验，来评估诊断测试和治疗益处的证据强度。循证医学疗法有限的成功率表明，目前的证据水平可能无法充分应对脱发的复杂本质，而且治疗脱发的医生可能在充分研究有力证据以支撑其治疗方法方面有所欠缺。在此背景下，精准医学（PM）的概念正在不断发展。精准医学是指根据患者的基因背景及其他分子或细胞分析，针对患者的个体特征定制医疗护理，同时将患者分为对特定疾病的易感性、这些疾病的生物学特性或预后、或对特定治疗的反应存在差异的亚群。随着毛发研究的进展、分子生物学和遗传学的强大工具以及创新技术的出现，我们拥有了强大的科学数据和工具，可将精准医学的概念应用于毛发医学实践。最后，必须对与精准医学的发展和疗效相关的数据库进行分析，并以此为基础形成循证个性化毛发医学。
