在以证据为基础的医学中需要展望
1Department of Family Practice, Medical College of Virginia, Virginia Commonwealth University, Fairfax 22033, USA. shwoolf@aol.com
JAMA
|December 28, 1999
概括
医疗保健的优先事项不匹配,更多的支出用于治疗而不是预防. 提出了一个新的系统来比较干预的有效性,帮助政策和个人健康决策.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 公共卫生政策 公共卫生政策
背景情况:
- 越来越多的临床试验数据凸显了系统信息合成的必要性.
- 目前的医疗保健系统缺乏资源来比较政策和个人决策的干预效果.
- 存在不匹配的优先事项,在疾病治疗上投入大量资金,而不是初级预防和健康促进.
研究的目的:
- 提出一个系统来比较卫生干预措施的相对有效性.
- 使决策者,临床医生和个人能够根据证据优先考虑干预措施.
- 解决医疗保健中基于证据的预测的迫切需要.
主要方法:
- 书籍证据收集中心的发展.
- 模拟建模用于估计干预的好处和危害.
- 初级预防与治疗有效性的比较分析.
主要成果:
- 初级预防策略 (如戒烟,运动) 显示出比心血管疾病治疗更大的死亡率降低潜力.
- 目前的医疗保健支出不成比例地倾向于治疗而不是预防.
- 个人层面的分析可以帮助患者做出明智的健康选择.
结论:
- 对证据评估的系统方法对于将医疗保健优先事项与人口健康需求相协调至关重要.
- 建议的证据收集和模拟工具可以指导资源分配和临床实践.
- 优先考虑基于证据的初级预防对于改善整体健康结果至关重要.
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