从循证医学到循证科学的必然趋势
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摘要
现代社会具体问题大多具有综合性和复杂性,导致知识生产专门化和知识需求综合化的矛盾日益突出,跨学科合作是提高科学研究有效性和可转化性的措施之一。循证医学提倡遵循科学透明的原则,开展以证据为基础的研究,充分考虑患者意愿,注重研究结果的实践转化,进行后效评价并止于至善。将循证医学实践模式与其他学科进行优势联合,共同创新会极大拓展科学研究方法和思维模式,成为提高科学研究质量,推动成果转化的有效途径。
The majority of problems are comprehensive and complex in the modern society, which leads to the increasing contradictions in the specialization and comprehensiveness of knowledge. Interdisciplinary cooperation is one approach to improve the effectiveness and transferability. The primary principle of evidence-based medicine is its scientific and transparent procedures. It combines the patient's preferences with clinical experience and the bestevidence. Meanwhile, evidence-based medicine is focused on how to transfer research outcomes into practice and the re-evaluation of the result of practice in order to striving for perfections. Combining this practical pattern of evidence-basedmedicine with other disciplines can have a significant improvement on scientific methods and thinking patterns, andbecome an effective way to improve the quality of scientific research and promote the transformation.
The majority of problems are comprehensive and complex in the modern society, which leads to the increasing contradictions in the specialization and comprehensiveness of knowledge. Interdisciplinary cooperation is one approach to improve the effectiveness and transferability. The primary principle of evidence-based medicine is its scientific and transparent procedures. It combines the patient's preferences with clinical experience and the bestevidence. Meanwhile, evidence-based medicine is focused on how to transfer research outcomes into practice and the re-evaluation of the result of practice in order to striving for perfections. Combining this practical pattern of evidence-basedmedicine with other disciplines can have a significant improvement on scientific methods and thinking patterns, andbecome an effective way to improve the quality of scientific research and promote the transformation.
引文
1李幼平,李静,孙鑫,等.循证医学在中国的发展:回顾与展望.兰州大学学报(医学版),2016, 42(2):15-18.
2陈耀龙,李幼平,杜亮,等.医学研究中证据分级和推荐强度的演进.中国循证医学杂志,2008, 8(2):127-133.
3 Available at:https://www.cochranelibrary.com/central.
4 Available at:https://www.cochranelibrary.com/cdsr/reviews.
5米娜瓦尔·阿不都,郝园,孔翔瑜,等.中国临床试验注册10年:现状与问题.中国循证医学杂志,2018,18(5):398-402.
6 Available at:https://www.clinicaltrials.gov/.
7中国临床试验注册中心.Available at:http://www.chictr.org.cn/searchproj.aspx.
8 Reporting guidelines. Enhancing the quality and transparency of health research. Available at:http://www.equatornetwork.org/?post_type=eq_guidelines&eqguidelines_study_desig n=0&eqguidelines_clinical_specialty=0&eqguidelines_report_secti on=0&s+CONSORT+extension&btnsubmit=Search+Reporting+G uidelines.
9 IOM. Clinical practice guidelines we can trust. Washington, DC:The National Academies Press, 2011.
10陈耀龙,胡嘉元,李承羽,等.中国临床实践指南的发展与变革.中国循证医学杂志,2018, 18(8):787-792.
11 Available at:http://www.g-i-n.net/library/internationalguidelineslibrary.
12 Available at:http://www.guideline.gov/.
13 Chen Y, Wang C, Shang H, et al. Clinical practice guidelines in China. BMJ, 2018, 360:j5158.
14 Miranda H. Great Medical Advance:sanitation. Available at:https://www.webmd.com/a-to-z-guides/news/20070119/greatestmedical-advancement-sanitation#1.
15邝心颖,李幼平,张鸣明.2017年Cochrane带给中国的机遇.中国循证医学杂志,2018, 18(8):1-7.
16拜争刚,赵坤,刘丹,等.循证社会科学的推动者:Campbell协作网.中国循证医学杂志,2018,18(10):1-6.
17 Millennium development goals. Available at:http://www.un.org/millenniumgoals/bkgd.shtml.
18 Sustainable development goals. Available at:https://www.un.org/sustainabledevelopment/zh/.
19中共中央、国务院.“健康中国2030”规划纲要.Available at:http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
20国务院.中医药健康服务发展战略规划纲要(2016-2030).Available at:http://www.gov.cn/zhengce/2016-02/26/content_5046738.htm.
21中华人民共和国中医药法.Available at:http://www.gov.cn/xinwen/2016-12/26/content_5152773.htm.
22 “十三五”卫生与健康科技创新专项规划.Available at:http://www.most.gov.cn/tztg/201706/t20170613_133484.htm.
23朱金富,李功迎,主编.医患沟通学.北京:高等教育出版社,2016.
24健康报.医联发布2017中国医生生存现状调研报告,超八成医生有睡眠问题,2017-09-25. Available at:http://www.jkb.com.cn/healthnews/2017/0925/418506.html.
25 DiCenso A, Guyatt G, Ciliska D. Evidence-based nursing:a guide to clinical practice. St. Louise:Elsevier Mosby, 2005.
26 Available at:http://joannabriggs.org/.
27 Kitson AL, Rycroft-Malone J, Harvey G, et al. Evaluating the successful implementation of evidence into practice using the PARiHS framework:theoretical and practical challenges.Implement Sci, 2008, 3:1.
28党海霞,张俊华,刘保延.中医药传承创新健康服务体系的战略研究.中国工程科学,2017,19(2):84-87.
29李幼平,主编.实用循证医学.北京:人民卫生出版社,2018.
30田金洲,张伯礼,高学敏,等.制定中成药治疗优势病种临床应用指南的指导意见.中国中西医结合杂志,2018, 38(1):7-11.
31世界卫生组织药物政策与标准司,国际药学联合会.开展药学实践-以患者为中心(2006版).Available at:http://www.doc88.com/p-1794600166996.html.
32李幼平,主编.实用循证医学.北京:人民卫生出版社,2018.
33李幼平,主编.实用循证医学.北京:人民卫生出版社,2018.
34 Muir G.循证医学的未来是患者循证选择.中国循证医学杂志,2005,5(3):180-184.
35英国政府.政府现代化.Available at https://www.wbginvestmentclimate.org/uploads/modgov.pdf.
36英国内阁办公室战略制定小组.21世纪专业政策制定.Available at:http://dera.ioe.ac.uk/6320/1/profpolicymaking.pdf.
37李幼平,杨晓妍,陈耀龙,等.我国公共卫生领域的循证决策与管理-挑战与探索.中国循证医学杂志,2008, 8(11):945-950.
38 Available at:http://www.who.int/features/2005/wha58/en/.
39李洋,彭伟霞,丁永明.五星级医生的培养.上海预防医学杂志,2007,(7):317-319, 325.
40杨宇海,邱伟华.世界医学教育联合会和全球医学教育认证.上海教育评估研究,2013, 9(3):29-32.
41美国中华医学基金会.全球医学教育最低基本要求.医学教育,2002,(4):23-25.
42周加仙.走出循证教育决策与实践.外国中小学教育,2017, 6:9-16.
43 Jocalyn Clark,姚巡.学院医学未来展望-ICRAM远景预案.中国循证医学杂志,2005, 5(8):589-590, 640.
44拜争刚,齐铱,杨克虎.等循证社会科学的起源、现状及展望.中国循证医学杂志,2018, 18(10):1118-1121.
2陈耀龙,李幼平,杜亮,等.医学研究中证据分级和推荐强度的演进.中国循证医学杂志,2008, 8(2):127-133.
3 Available at:https://www.cochranelibrary.com/central.
4 Available at:https://www.cochranelibrary.com/cdsr/reviews.
5米娜瓦尔·阿不都,郝园,孔翔瑜,等.中国临床试验注册10年:现状与问题.中国循证医学杂志,2018,18(5):398-402.
6 Available at:https://www.clinicaltrials.gov/.
7中国临床试验注册中心.Available at:http://www.chictr.org.cn/searchproj.aspx.
8 Reporting guidelines. Enhancing the quality and transparency of health research. Available at:http://www.equatornetwork.org/?post_type=eq_guidelines&eqguidelines_study_desig n=0&eqguidelines_clinical_specialty=0&eqguidelines_report_secti on=0&s+CONSORT+extension&btnsubmit=Search+Reporting+G uidelines.
9 IOM. Clinical practice guidelines we can trust. Washington, DC:The National Academies Press, 2011.
10陈耀龙,胡嘉元,李承羽,等.中国临床实践指南的发展与变革.中国循证医学杂志,2018, 18(8):787-792.
11 Available at:http://www.g-i-n.net/library/internationalguidelineslibrary.
12 Available at:http://www.guideline.gov/.
13 Chen Y, Wang C, Shang H, et al. Clinical practice guidelines in China. BMJ, 2018, 360:j5158.
14 Miranda H. Great Medical Advance:sanitation. Available at:https://www.webmd.com/a-to-z-guides/news/20070119/greatestmedical-advancement-sanitation#1.
15邝心颖,李幼平,张鸣明.2017年Cochrane带给中国的机遇.中国循证医学杂志,2018, 18(8):1-7.
16拜争刚,赵坤,刘丹,等.循证社会科学的推动者:Campbell协作网.中国循证医学杂志,2018,18(10):1-6.
17 Millennium development goals. Available at:http://www.un.org/millenniumgoals/bkgd.shtml.
18 Sustainable development goals. Available at:https://www.un.org/sustainabledevelopment/zh/.
19中共中央、国务院.“健康中国2030”规划纲要.Available at:http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
20国务院.中医药健康服务发展战略规划纲要(2016-2030).Available at:http://www.gov.cn/zhengce/2016-02/26/content_5046738.htm.
21中华人民共和国中医药法.Available at:http://www.gov.cn/xinwen/2016-12/26/content_5152773.htm.
22 “十三五”卫生与健康科技创新专项规划.Available at:http://www.most.gov.cn/tztg/201706/t20170613_133484.htm.
23朱金富,李功迎,主编.医患沟通学.北京:高等教育出版社,2016.
24健康报.医联发布2017中国医生生存现状调研报告,超八成医生有睡眠问题,2017-09-25. Available at:http://www.jkb.com.cn/healthnews/2017/0925/418506.html.
25 DiCenso A, Guyatt G, Ciliska D. Evidence-based nursing:a guide to clinical practice. St. Louise:Elsevier Mosby, 2005.
26 Available at:http://joannabriggs.org/.
27 Kitson AL, Rycroft-Malone J, Harvey G, et al. Evaluating the successful implementation of evidence into practice using the PARiHS framework:theoretical and practical challenges.Implement Sci, 2008, 3:1.
28党海霞,张俊华,刘保延.中医药传承创新健康服务体系的战略研究.中国工程科学,2017,19(2):84-87.
29李幼平,主编.实用循证医学.北京:人民卫生出版社,2018.
30田金洲,张伯礼,高学敏,等.制定中成药治疗优势病种临床应用指南的指导意见.中国中西医结合杂志,2018, 38(1):7-11.
31世界卫生组织药物政策与标准司,国际药学联合会.开展药学实践-以患者为中心(2006版).Available at:http://www.doc88.com/p-1794600166996.html.
32李幼平,主编.实用循证医学.北京:人民卫生出版社,2018.
33李幼平,主编.实用循证医学.北京:人民卫生出版社,2018.
34 Muir G.循证医学的未来是患者循证选择.中国循证医学杂志,2005,5(3):180-184.
35英国政府.政府现代化.Available at https://www.wbginvestmentclimate.org/uploads/modgov.pdf.
36英国内阁办公室战略制定小组.21世纪专业政策制定.Available at:http://dera.ioe.ac.uk/6320/1/profpolicymaking.pdf.
37李幼平,杨晓妍,陈耀龙,等.我国公共卫生领域的循证决策与管理-挑战与探索.中国循证医学杂志,2008, 8(11):945-950.
38 Available at:http://www.who.int/features/2005/wha58/en/.
39李洋,彭伟霞,丁永明.五星级医生的培养.上海预防医学杂志,2007,(7):317-319, 325.
40杨宇海,邱伟华.世界医学教育联合会和全球医学教育认证.上海教育评估研究,2013, 9(3):29-32.
41美国中华医学基金会.全球医学教育最低基本要求.医学教育,2002,(4):23-25.
42周加仙.走出循证教育决策与实践.外国中小学教育,2017, 6:9-16.
43 Jocalyn Clark,姚巡.学院医学未来展望-ICRAM远景预案.中国循证医学杂志,2005, 5(8):589-590, 640.
44拜争刚,齐铱,杨克虎.等循证社会科学的起源、现状及展望.中国循证医学杂志,2018, 18(10):1118-1121.