Carneiro A V
Serviço de Medicina IV, Hospital de Santa Maria, Lisboa.
Acta Med Port. 1998 Aug-Sep;11(8-9):717-37.
Modern medical practice is an ever-changing process, and the doctor's need for information has been partially met by continuous medical education (CME) activities. It has been shown that CME activities have not prevented clinical knowledge, as well as medical practice, from deteriorating with time. When faced with the need to get the most recent and relevant information possible, the busy clinician has two major problems: most of the published medical literature is either irrelevant or not useful; and there is little time to read it. Evidence-based medicine constitutes a new paradigm for medical practice in the sense that it tries to transform clinical problems into well formulated clinical questions, selecting and critically appraising scientific evidence with predefined and rigorous rules. It combines the expertise of the individual clinician with the best external evidence from clinical research for rational, ethical and efficacious practice. Evidence-based medicine can be taught and practiced by physicians with different degrees of autonomy, with several subspecialties, working in the hospital or in outpatient clinics, alone or in groups.
现代医学实践是一个不断变化的过程，医生对信息的需求已通过继续医学教育（CME）活动得到部分满足。研究表明，继续医学教育活动并未能阻止临床知识以及医疗实践随着时间的推移而退化。当面临获取尽可能最新和相关信息的需求时，忙碌的临床医生面临两个主要问题：大多数已发表的医学文献要么不相关，要么没有用处；而且几乎没有时间去阅读。循证医学构成了医学实践的一种新范式，因为它试图将临床问题转化为精心构建的临床问题，按照预先定义的严格规则选择并批判性地评估科学证据。它将个体临床医生的专业知识与临床研究的最佳外部证据相结合，以实现合理、符合伦理且有效的实践。循证医学可以由具有不同自主程度、多个亚专业、在医院或门诊工作、单独或分组工作的医生进行传授和实践。
