Saad E D, Grunspun H
Serviços de Clínica Médica de Emergência, Universidade de São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1996 Jan-Feb;51(1):34-6.
Evidence-based medicine has been described as a new approach to teaching and practicing clinical medicine. Although the search for evidence is an established practice among physicians, what is being proposed is the systematic gathering and critical interpretation of data, which can then be used in the appropriate context. The main objective is to provide better care for patients. This is accomplished by transforming clinical problems in specific questions to be answered by searching the literature for the levels of evidence favoring the possible interventions for one particular case. This has to be done in a systematic and conscientious fashion. Through its method, evidence-based medicine places less value on clinical experience, the study understanding of pathophysiology, and common sense; instead, it emphasizes observation, levels of evidence, and critical interpretation of original literature. In this manner, evidence-based medicine may be seen by the authoritarian physician as a threat. Other obstacles to the acceptance of the method include lack of time and lack of familiarity with computers. One important limitation of evidence-based medicine is the incomplete or contradictory evidence available in many areas of clinical medicine, or the so-called "grey zones". We outline the main aspects of evidence-based medicine, expecting a growing interest among brazilian physicians for this useful clinical tool.
循证医学已被描述为一种教授和实践临床医学的新方法。虽然在医生中寻找证据是一种既定的做法,但现在提出的是系统地收集和批判性地解释数据,然后将其应用于适当的情境中。主要目标是为患者提供更好的护理。这是通过将临床问题转化为特定问题来实现的,这些问题需要通过搜索文献来找到支持针对某一特定病例可能干预措施的证据水平。这必须以系统和认真的方式进行。通过其方法,循证医学不太重视临床经验、对病理生理学的研究理解和常识;相反,它强调观察、证据水平和对原始文献的批判性解释。以这种方式,循证医学可能会被独裁的医生视为一种威胁。接受该方法的其他障碍包括时间不足和对计算机不熟悉。循证医学的一个重要局限性是临床医学许多领域存在不完整或相互矛盾的证据,即所谓的“灰色地带”。我们概述了循证医学的主要方面,期望巴西医生对这种有用的临床工具的兴趣日益浓厚。