循证医学--21世纪临床医学与卫生决策的新支点

20世纪后叶,由于疾病谱转变,医疗费用激增、卫生资源绝对不足以及低效率使用,卫生管理部门和医生对科学决策的要求增加。20世纪90年代初应运而生的循证医学,以临床流行病学、系统评价和卫生技术评估为三大技术支柱,强调在临床实践中遵循当前可得到的最佳临床研究证据,结合医生临床经验和患者需求科学决策与实践,已在许多发达国家取得成功经验。高质量循证医学证据已被WHO、澳大利亚等国家、组织作为决策依据,建立新的运作模式和机制。作为最大的发展中国家,我国正面临诸多卫生问题。引进、消化、吸收和使用循证医学将为促进我国卫生决策科学化,提高医药行业竞争力,医疗服务水平,促进医学普及,保障患者和医生的权利起到积极作用。

Evidence-based medical approach to clinical medicine and health policy-making in the 21st century

In the 20 th century,due to the change of disease spectra ,rapid increase of health expenditure and imbalanced distribution of health res ources,the health management sectors and doctors increasingly demand the scien tific decision-making.With the development of clinical evidences and research ,evidence-based medicine(EBM)became emerged in the early1990's.EBM,the medical science in compliance with the best available clinical evidence,integr ates clinical epidemiology(CE),systematic reviews (SRs)and health technolog y assessment (HTA)as the major technology,to emphasize that the clinical prac tice should be based on the combination of the best available clinical evidence ,medical experiences and patient desire to cope with the demand of medical dec ision-making.Some governments and international organizations like WHO,and Au stralia have now adopted the high-quality evidence of EBM for decision-making.A s the largest developing country,China is challenged by variety of health prob lems.The introduction,adaptation and implementation of EBM will improve the de cision-making and health care services,which should enhance the competitive cap acity of medical and pharmaceutical manufactures,as well as promote the popular ization of EBM,and protect the doctors and patients rights.