心血管病的循证医学方法

摘要

Evidence-based medicine (EBM) requires integration of available ‘best’ clinical evidence,clinician's judgment as well as patient's wishes and expectations.In this paper,we addressed the EBM framework for clinical decision making clinical practice in cardiovascular diseases.Evidence evaluated and interpreted are crucial tools for EBM.EBM has had a profound impact on the treatment of cardiovascular diseases,and confirmed the efficacy of certain controversial interventions.On the other hand,certain widely used conventional strategies for cardiovascular diseases had been proved to be ineffective.Yet,the scientific evidence from China is under resourced to impact the ability to achieve effective actions.We suggest to carry out more high-quality randomized clinical trials to support effective EBM clinical practice.%实施循证医学(evidence-based medicine,EBM)意味着医生需要综合考虑最佳临床研究证据、医生的临床经验和患者的意见进行临床决策.本文针对心血管疾病临床实践中临床决策的EBM框架进行了探讨.认为获得最佳证据,需要对不同来源的证据进行科学的评估和解读.EBM对心血管疾病诊疗领域产生了深远的影响,肯定了某些备受争议干预措施的疗效,而一些曾经认为有效的药物因被证明患者无获益而退出临床应用.我国心血管病的科学证据资源不足,影响到循证实践的能力.建议开展更高质量的随机临床试验,以支持有效的循证医学临床实践.