Ellis J, Mulligan I, Rowe J, Sackett D L
Nuffield Department of Clinical Medicine, Oxford-Radcliffe NHS Trust, Headington, UK.
Lancet. 1995 Aug 12;346(8972):407-10.
For many years clinicians have had to cope with the accusation that only 10-20% of the treatments they provide have any scientific foundation. Their interventions, in other words, are seldom "evidence based". Is the profession guilty as charged? In April, 1995, a general medical team at a university-affiliated district hospital in Oxford, UK, studied the treatments given to all 109 patients managed during that month on whom a diagnosis had been reached. Medical sources (including databases) were then searched for randomised controlled trial (RCT) evidence that the treatments were effective. The 109 primary treatments were then classified: 82% were evidence based (ie, there was RCT support [53%] or unanimity on the team about the existence of convincing non-experimental evidence [29%]). This study, which needs to be repeated in other clinical settings and for other disciplines, suggests that earlier pessimism over the extent to which evidence-based medicine is already practised is misplaced.
多年来，临床医生一直不得不应对这样的指责：他们所提供的治疗中只有10%至20%有任何科学依据。换句话说，他们的干预措施很少是“基于证据的”。这个行业是否如指控的那样有罪呢？1995年4月，英国牛津一家大学附属医院的一个普通医疗团队研究了当月收治的所有109例已确诊患者所接受的治疗。然后在医学资料来源（包括数据库）中搜索随机对照试验（RCT）证据，以证明这些治疗是有效的。然后对这109种主要治疗方法进行了分类：82%是基于证据的（即有随机对照试验的支持[53%]，或者团队对存在令人信服的非实验性证据达成一致意见[29%]）。这项研究需要在其他临床环境和其他学科中重复进行，它表明，早期对循证医学实际应用程度的悲观态度是错误的。
