Reinhart W H
Medizinische Klinik, Kantonsspital Chur.
Schweiz Med Wochenschr. 1996 Mar 30;126(13):512-6.
"Omit what is unnecessary-do what is necessary" is a description of rational medicine. "Unnecessary" diagnostic procedures are not uncommon. Excessive laboratory testing and routine X-ray represent primarily financial burdens. The aim of diagnostic procedures is not to obtain absolute diagnostic certainty, but to minimize diagnostic uncertainty to a point where rational treatment can be offered. The number and type of diagnostic and therapeutic procedures correlate with the rate of iatrogenic damage. There are difficult situations, such as futile treatment in intensive care units, which are complex and must be solved in consensus with patients and/or their relatives. "Necessary"p6 diagnostic and therapeutic procedures are less numerous than unnecessary ones. In conclusion, rational medicine-which only does what is necessary and omits what is unnecessary-is an ideal model with an optimum cost-benefit as well as risk-benefit ratio.
“省略不必要的，做必要的事”是对合理医学的一种描述。“不必要的”诊断程序并不罕见。过度的实验室检测和常规X光检查主要带来经济负担。诊断程序的目的不是获得绝对的诊断确定性，而是将诊断不确定性降至可提供合理治疗的程度。诊断和治疗程序的数量及类型与医源性损伤发生率相关。存在一些困难情况，比如重症监护病房中的无效治疗，这类情况很复杂，必须与患者和/或其亲属达成共识来解决。“必要的”诊断和治疗程序比不必要的要少。总之，只做必要之事并省略不必要之事的合理医学是一种具有最佳成本效益以及风险效益比的理想模式。
