Jacobson L D, Edwards A G, Granier S K, Butler C C
Department of General Practice, University of Wales, College of Medicine.
Br J Gen Pract. 1997 Jul;47(420):449-52.
Evidence-based medicine (EBM) aids clinical decision making in all fields of medicine, including primary care. General practice is characterized by particular emphasis on the doctor-patient relationship and on biomedical, personal and contextual perspectives in diagnosis. Most evidence available to general practitioners (GPs) addresses only the bio-medical perspective and is often not directly applicable to primary care, as it derives from secondary or tertiary care. Emphasis on the biomedical domain and the randomized controlled trial (RCT) alone reflects a reductionist approach that fails to do justice to the philosophy of general practice. The art of medicine is founded on context, anecdote, patient stories of illness and personal experience, and we should continue to blend this with good quality and appropriate research findings in patient care.
循证医学（EBM）有助于在包括初级保健在内的所有医学领域进行临床决策。全科医疗的特点是特别强调医患关系以及诊断中的生物医学、个人和背景视角。全科医生（GPs）可获得的大多数证据仅涉及生物医学视角，并且通常不能直接应用于初级保健，因为这些证据来自二级或三级医疗。仅强调生物医学领域和随机对照试验（RCT）反映了一种还原论方法，这种方法无法公正地体现全科医疗的理念。医学艺术建立在背景、轶事、患者的疾病故事和个人经验之上，我们应该继续将其与患者护理中高质量且合适的研究结果相结合。
