循证医学:有利有弊

Yakusevich V. V.
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引用次数: 0

摘要

本文涵盖了从临床经验和循证医学的角度对药物疗效和安全性进行比较评估的基本信息。强调证据医学尽管有诸多优点,但与“观点医学”并不矛盾。已经提出了进行随机临床试验的基本规则,被称为最现代的证据收集方法。介绍了证据的主要标准。同时强调循证医学也有其弊端。其中最主要的问题是无法将临床试验的结果用于治疗所有有问题的患者。描述了临床试验和真实世界数据(RWD/RWE)之间比较结果的原理——RCT DUPLICATE项目。作者对临床试验进行和报告的主要缺点提出了看法。对临床试验中的一些伦理问题进行了评估。作者声称,为特定患者选择最佳治疗策略应结合循证医学、临床经验和历史数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
EVIDENCE-BASED MEDICINE: OBVIOUS BENEFITS AND HIDDEN DRAWBACKS
The article covers basic information on the comparative evaluation of drugs efficacy and safety from the standpoint of both clinical experience and evidence-based medicine. It is emphasized that despite all its advantages evidencebased medicine does not contradict the "opinion-based medicine". There have been presented the basic rules for conducting randomized clinical trials referred to as the most modern method of evidence collection. The main criteria of evidence are described. At the same time, it is emphasized that evidence-based medicine has its drawbacks. The main of them - is inability to transfer the results obtained in a clinical trial to the treatment of all patients with the disease in question. The principle of comparing results between clinical trial and real-world data (RWD / RWE) is described – the project RCT DUPLICATE. The author’s opinion on the main drawbacks in conducting and reporting clinical trials is presented. A number of ethical issues in clinical trials is evaluated. The author claims that the selection of optimal treatment strategy for a particular patient should rely on combination of evidence-based medicine, clinical experience, and historical data as well.
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