如何运用系统评价结果进行临床实践

循证医学实践需要高质量证据。系统评价/Meta分析通过立题、检索文献、筛选文献、评价文献质量、收集资料、分析资料、解释结果、更新原有评价等严格系统的制作过程,确保研究结果和结论的真实性和可靠性,因此被公认为论证强度最高的证据。然而临床医生在将其具体应用于临床实践之前还需考虑该系统评价结果是否适用于你的患者,是否包含了所有可能的重要结果,其干预措施对患者的诊治益处在临床上是否重要,对患者是否利大于弊,此外,还需要考虑所需治疗费用以及患者的价值取向。循证医学临床实践因需要而产生,同时它也因为真实性、患者的个体化以及疾病的复杂性而不断更新。也正是因为它的缺陷性和不完美性,循证临床实践才具有更广阔的发展空间。

How to Apply the Results of Systematic Reviews to Clinical Practice

Evidence-based medicine （EBM） practice requires high-quality evidence. With the rigorous and system- atic processes including legislation, literature search, literature screening, literature quality assessment, data collection, data analysis, results interpretation and original evaluation updating, the systematic review/meta-analysis is recognized as the clinical evidence with highest intensive argument for reasons of ensuring the authenticity and reliability of the findings and conclusions. Before it is applied to the specific clinical practice, a clinical doctor has to evaluate whether its results are applicable to patients or not, whether it contains all possible important results or not, whether the diagnosis and treatment benefiting from its interventions are clinically significant to patients or not, and additionally, has to take the treatment expense and patient＇s value orientation into consideration. EBM clinical practice occurs for demands, and updates con- sciously for its authenticity, patient＇s individuation and disease complexity. It has a broad development space for no other reason than its defect and imperfection.