Triposkiadis Filippos, Brutsaert Dirk L
Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41500 Larissa, Greece.
Department of Cardiology, European University Cyprus, 1516 Nicosia, Cyprus.
J Clin Med. 2025 Jul 17;14(14):5094. doi: 10.3390/jcm14145094.
Early medical traditions include those of ancient Babylonia, China, Egypt, and India. The roots of modern Western medicine, however, go back to ancient Greece. During the Renaissance, physicians increasingly relied on observation and experimentation to understand the human body and develop new techniques for diagnosis and treatment. The discovery of antibiotics, antiseptics, and other drugs in the 19th century accelerated the development of modern medicine, the latter being fueled further by advances in technology, research, a better understanding of the human body, and, most recently, the introduction of evidence-based medicine (EBM). The EBM model de-emphasized intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision-making and stressed the examination of evidence from clinical research. A later EBM model additionally incorporated clinical expertise and the latest model of EBM patients' preferences and actions. In this review article, we argue that in the era of precision medicine, major EBM principles must be based on (a) the systematic identification, analysis, and utility of big data using artificial intelligence; (b) the magnifying effect of medical interventions by means of the physician-patient interaction, the latter being guided by the physician's expertise, intuition, and philosophical beliefs; and (c) the patient preferences, since, in healthcare under precision medicine, the patient will be a central stakeholder contributing data and actively participating in shared decision-making.
早期的医学传统包括古代巴比伦、中国、埃及和印度的传统。然而，现代西方医学的根源可以追溯到古希腊。在文艺复兴时期，医生越来越依赖观察和实验来了解人体，并开发新的诊断和治疗技术。19世纪抗生素、防腐剂和其他药物的发现加速了现代医学的发展，技术进步、研究进展、对人体的更深入了解，以及最近循证医学（EBM）的引入，进一步推动了现代医学的发展。循证医学模式不再强调将直觉、非系统的临床经验和病理生理原理作为临床决策的充分依据，而是强调对临床研究证据的审查。后来的循证医学模式还纳入了临床专业知识以及患者偏好和行为的最新模式。在这篇综述文章中，我们认为在精准医学时代，循证医学的主要原则必须基于：（a）利用人工智能对大数据进行系统的识别、分析和应用；（b）通过医患互动增强医疗干预的效果，而这种互动由医生的专业知识、直觉和哲学信念引导；（c）患者的偏好，因为在精准医学的医疗保健中，患者将是提供数据并积极参与共同决策的核心利益相关者。
