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[循证公共卫生:观点与具体实施因素]

[Evidence-based public health: perspectives and specific implementation factors].

作者信息

Rehfuess Eva A, Zhelyazkova Ana, von Philipsborn Peter, Griebler Ursula, De Bock Freia

机构信息

Lehrstuhl für Public Health und Versorgungsforschung, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, Marchioninistr. 17, 81377, München, Deutschland.

Pettenkofer School of Public Health, München, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 May;64(5):514-523. doi: 10.1007/s00103-021-03308-x. Epub 2021 Apr 13.

Abstract

An evidence-based approach is considered a central requirement in the public health system. Five general principles apply in evidence-based medicine as well as in evidence-based public health (EBPH). These comprise a systematic approach, transparency in relation to uncertainty, integration and participation, management of conflicts of interest, and a structured, reflective process. This article aims to promote a common understanding of what taking an evidence-based approach entails in the field of public health.We explored the international understanding of EBPH through systematic literature searches of definitions, concepts, and models regarding an evidence-based approach in public health. In this manner, 20 English sources and one German source were identified and examined using content analysis. Beyond the above-described general principles, characteristics of these perspectives are concerned with a population orientation, the underlying concept of evidence, disciplines, and stakeholder groups to be involved in the process, as well as relevant criteria and necessary competencies for implementing an evidence-based approach.Based on this, and taking into account methodological developments to address complexity, four specific implementation factors of EBPH can be derived. These include theory, interdisciplinarity, context-sensitivity, and complexity as well as general societal aspects.The practical implementation of EBPH requires human and financial resources as well as competencies - among others, for conducting systematic reviews of the effectiveness of measures, examining other relevant questions in a scientific manner, and establishing transparent processes to formulate recommendations.

摘要

循证方法被视为公共卫生系统的一项核心要求。循证医学和循证公共卫生(EBPH)都适用五条一般原则。这些原则包括系统方法、与不确定性相关的透明度、整合与参与、利益冲突管理以及结构化的反思过程。本文旨在促进对公共卫生领域采用循证方法意味着什么达成共识。我们通过系统检索关于公共卫生循证方法的定义、概念和模型的文献,探索了国际上对EBPH的理解。通过这种方式,确定了20篇英文文献和1篇德文文献,并使用内容分析法进行了审查。除上述一般原则外,这些观点的特征还涉及人群导向、证据的基本概念、学科、参与该过程的利益相关者群体,以及实施循证方法的相关标准和必要能力。基于此,并考虑到应对复杂性的方法学发展,可以得出EBPH的四个具体实施因素。这些因素包括理论、跨学科性、情境敏感性和复杂性以及一般社会层面。EBPH的实际实施需要人力和财力资源以及能力——其中包括对措施有效性进行系统评价、以科学方式审查其他相关问题以及建立透明程序以制定建议等能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3715/8087605/a0fb44f443a2/103_2021_3308_Fig1_HTML.jpg

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