Department of Emergency Medicine, Royal Perth Hospital, The University of Western Australia, Perth, Western Australia, Australia.
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia.
Emerg Med Australas. 2021 Apr;33(2):385-387. doi: 10.1111/1742-6723.13730. Epub 2021 Jan 31.
Antifragility is a property of things that benefit from shocks, randomness and uncertainty and love adventure and risk. This describes emergency medicine. Improving evidence-based medicine requires a learning health system, where the whole system is constructed to advance patient care via research driven excellence. So we need to develop our own evidence base by embedding research into everyday practice. Clinical research is messy but the repeated stress testing of clinical practice via research enhances our antifragility. This is even more important because our world is complex, as are humans. Unfortunately, the human brain is hard wired for simplicity, making us disinclined to challenge the status quo. Yet probably <10% of our practice is supported by high-level evidence. Research is altruistic and a form of kindness for our patients, which includes having a culture of research within a learning health system, so that we can be thoughtful!
反脆弱性是指事物从冲击、随机性和不确定性中受益，并喜欢冒险和风险的特性。这描述了急诊医学。提高循证医学需要一个学习型医疗系统，通过卓越的研究驱动整个系统来推进患者护理。因此，我们需要通过将研究嵌入日常实践来建立自己的证据基础。临床研究是混乱的，但通过研究对临床实践进行反复的压力测试可以增强我们的反脆弱性。这一点更为重要，因为我们的世界是复杂的，人类也是如此。不幸的是，人类的大脑天生就倾向于简单，这使得我们不愿意挑战现状。然而，我们的实践中只有 <10% 左右得到了高级别的证据支持。研究是对我们患者的利他主义和一种善意，包括在学习型医疗系统中建立研究文化，以便我们能够深思熟虑！
