Baidu
map

LANCET:一分钟了解循证医学的进展

2017-02-23 MedSci MedSci原创

为了回应对公开证据的理解和使用的限制,循证医学(EBM)在20世纪90年代初开始成为了一项运动。 EBM的初始焦点是教育临床医生理解和使用已发表的文献以优化临床护理,包括系统评价的科学性。 而后,EBM逐渐认识到证据的局限性,并越来越强调需要通过共同决策将证据的重要性评价与患者的价值观和偏好相结合。在另一个进展中,EBM结合并进一步开发了由研究者在20世纪80年代开创的可靠的临

为了回应对公开证据的理解和使用的限制,循证医学(EBM)在20世纪90年代初开始成为了一项运动。 

EBM的初始焦点是教育临床医生理解和使用已发表的文献以优化临床护理,包括系统评价的科学性。 

而后,EBM逐渐认识到证据的局限性,并越来越强调需要通过共同决策将证据的重要性评价与患者的价值观和偏好相结合。

在另一个进展中,EBM结合并进一步开发了由研究者在20世纪80年代开创的可靠的临床实践指南的科学。 

EBM对临床医学的持续贡献包括将医学实践置于坚实的科学基础上,发展更复杂的证据层次,认识到患者价值和偏好在临床决策中的关键作用,以及开发方法论生成可信的建议。

原始出处:
Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet. 2017 Feb 16. pii: S0140-6736(16)31592-6. doi: 10.1016/S0140-6736(16)31592-6.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1828781, encodeId=b1471828e812b, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Sep 27 02:16:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379458, encodeId=86c313e9458f8, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449708, encodeId=f6db1449e0825, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177834, encodeId=b6a31e7834ce, content=1分钟没看到啥, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ef81637034, createdName=myshanshan, createdTime=Sat Feb 25 08:47:35 CST 2017, time=2017-02-25, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1828781, encodeId=b1471828e812b, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Sep 27 02:16:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379458, encodeId=86c313e9458f8, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449708, encodeId=f6db1449e0825, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177834, encodeId=b6a31e7834ce, content=1分钟没看到啥, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ef81637034, createdName=myshanshan, createdTime=Sat Feb 25 08:47:35 CST 2017, time=2017-02-25, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1828781, encodeId=b1471828e812b, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Sep 27 02:16:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379458, encodeId=86c313e9458f8, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449708, encodeId=f6db1449e0825, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177834, encodeId=b6a31e7834ce, content=1分钟没看到啥, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ef81637034, createdName=myshanshan, createdTime=Sat Feb 25 08:47:35 CST 2017, time=2017-02-25, status=1, ipAttribution=)]
    2017-02-25 xjy04
  4. [GetPortalCommentsPageByObjectIdResponse(id=1828781, encodeId=b1471828e812b, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Sep 27 02:16:00 CST 2017, time=2017-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379458, encodeId=86c313e9458f8, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449708, encodeId=f6db1449e0825, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Sat Feb 25 12:16:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177834, encodeId=b6a31e7834ce, content=1分钟没看到啥, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ef81637034, createdName=myshanshan, createdTime=Sat Feb 25 08:47:35 CST 2017, time=2017-02-25, status=1, ipAttribution=)]
    2017-02-25 myshanshan

    1分钟没看到啥

    0

相关资讯

循证医学的四大尴尬

曾几何时,循证医学被全世界医生当做医界“圣经”一样遵从。代表循证医学的《临床证据》也风靡全球,由于这本书是一个不断更新的国际循证医学资源,它提供了大量常见疾病现有最好的研究证据,对医生临床治疗作决定很有帮助。然而,最近媒体上的一则消息却使得循证医学的“权威”受到了挑战。这则消息是来自于四川省人民医院的江华、杨浩、彭谨等人,其核心观点是:最新研究发现,Meta-分析在方法学上有其先天不足和不可靠性,

段涛:大数据加速医疗模式整合

2015年9月10日,由生物谷主办的2015(第二届)生物医疗大数据高峰论坛在上海斯波特大饭店举办。来自上海市第一妇婴保健院的段涛院长在会议上发表了题为"大数据加速医疗模式整合"的精彩报告。段院长从临床医生的角度,从循证医学谈起,提出精准医疗及大数据对未来医疗健康模式影响的看法。1.目前循证医学证据的样本量与大数据的样本量比起来可谓凤毛麟角,建立和使用医疗大数据库可使循证医学证据更充分、更完善。2

JAMA:关于循证医学,这有你想知道的一切

Normal 0 10 pt 0 2 false false false EN-US ZH-CN X-NONE

循证医学证据质量分级与推荐系统

1. 定量系统评价证据分级工具(GRADE) 卫生系统中证据推荐分级的评估、制订与评价(The Grading of Recommendations Assessment, Development and Evaluation, GRADE)系统是当前证据质量和推荐强度分级的国际标准之一,由GRADE工作组于2004年正式推出,适用于临床实践指南、系统评价和卫生技术评估,最主要应用领域是临床实践

李博:循证是一种临床决策思维模式

认识李博,是源于参加他的循证读书会,也正是因为参加读书会,我提前看了很多关于他的内容以及他写的书,发现一个很有意思的地方:他对循证医学的执着已经延伸到生活中的各个方面,因为他有时候可以为一次聚会选地点而做出一份大众点评的评价表格。在安静的书店,第一眼见到他的时候感觉他很亲和,并不是那种一板一眼的人,但随着大家热烈的讨论才发现,他是个极度认真的人,为了搜索医学文献和做系统评价,可以打200多个电话;

循证医学及其中的决策问题

注:太簇注于2007年8月1日晚明嘉靖40至43年间,西方接连诞生了两位开天辟地的人物——先是培根(1561-1626)在英伦三岛横空出世,然后伽利略(1564-1642)于亚平宁半岛(亦称意大利半岛)降临人间。培根认为真正对人类有价值的知识来自于对自然的经验,并首倡了从经验中提炼知识的有效方法——归纳法。伽利略展示了观察与测量在获得可靠知识方面的巨大威力,是实验方法的父亲。这两位,就是已造福

Baidu
map
Baidu
map
Baidu
map