Hampton J R
Cardiovascular Medicine, University Hospital, Nottingham, UK.
J Eval Clin Pract. 1997 Apr;3(2):123-31. doi: 10.1046/j.1365-2753.1997.00094.x.
Much of cardiovascular disease can be treated on the basis of the results of large clinical trials and can be considered 'evidence-based'. However, trial results are not infallible and it is important to recognize their limitations. Despite the evidence, widespread variation exists in medical practice between and within countries; the reasons may be cultural, or may indicate poor medical education. Purchasing authorities have to do the best they can with available evidence, and our full evidence base needs to include costs; in some instances we now have evidence of benefit from treatment that we almost certainly cannot afford. Evidence-based medicine is a further - but possibly an acceptable - limitation to clinical freedom.
许多心血管疾病可以根据大型临床试验的结果进行治疗，并可被视为“循证医学”。然而，试验结果并非绝对可靠，认识到其局限性很重要。尽管有证据，但各国之间以及国内医疗实践中仍存在广泛差异；原因可能是文化方面的，也可能表明医学教育水平低下。采购部门必须根据现有证据尽最大努力，而我们完整的证据基础需要包括成本；在某些情况下，我们现在有治疗获益的证据，但我们几乎肯定负担不起。循证医学是对临床自主性的又一个限制——但可能是可以接受的限制。
